Other Symptoms of Intolerance

Anaphylactic shock reactions claimed to be caused by tartrazine and Sunset Yellow were reported in a patient receiving an enema of liquid castile soap (Trautlein and Mann 1978). Tests with components of the soap showed marked wheal and flare reactions to the dyes. It should be pointed out that positive skin test reactions to azo dyes are not found in patients with urticaria and asthma. 

Hagerman (1970) reported exacerbation of acne after a few days of exposure to azo dyes. Itching, skin rash, and fever were reported in three patients with im- 

Erythema multiforme-like symptoms were demonstrated to F. D, and C. Green No. 5 (Fast Green) which is a non-azo dye, approved for use in food, drugs and cosmetics in the United States (Grater 1976). Quinine present in bitter drinks may induce fixed reactions, toxic epidermal necrolysis, or a scarlatiniform rash (Derbes 1964 Calnan and Caron 1961 Callaway and Tate 1974). 

After provocation tests in patients with urticaria, various other symptoms such as sneezing, hoarseness, nasal congestion, sweating, irritability, and sensations of swelling, drowsiness, or heaviness in the head may be noted (Michaelsson and JuHLiN 1973). Such symptoms are, however, difficult to evaluate. Diffuse symptoms after administration of 50 mg tartrazine have also been reported by Neuman et al. (1978). Dextrose was used as placebo but details of its clinical effect were not described. Further studies in this area seem warranted. 

In 1960 there were epidemics in Germany and Holland called the margarine disease. The disease had a clinical picture similar to erythema multiforme and was attributed to an emulsifier used in the preparation of a certain brand of margarine. The Dutch epidemic was reviewed by Mali and Malten (1966). They emphasized that opinions were divided as to the etiological significance of margarine. 

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