Pseudo-allergic reactions

Triggering of asthma attacks in asthmatics. This side effect is a pseudo-allergic reaction where COX-inhibition increases the availability of substrates for lipoxygenase, which are converted to broncho-constrictive leukotriens... 

The direct histamine release evoked by several substances (e.g. codeine, dextran in certain rat strains or gelatine blood substitutes) led to the development of the concept of pseudo-allergic reactions by Paul Kallos [10]. 

Radio contrast media may cause serious immediate pseudo allergic reactions such as urticaria/angioedema, bron-chospasm, shock, and death. These reactions have been reduced with the introduction of non-ionic, lower-osmolality products. Because a small percentage of patients who have reacted previously to radiocontrast media will react if re-exposed, several steps should be taken to prevent reactions, including ... 

Its most important adverse effects are nephrotoxicity and ototoxicity. The risks for nephrotoxicity can be limited by adequate hydration. Marked nausea and vomiting are frequent. Only mild-to-moderate myelosuppression is seen. Pseudo-allergic reactions may occur which respond to intravenous epinephrine and corticosteroids or antihistamines. 

IgE and/or specifically reactive lymphocytes do not mediate many of the adverse reactions to cromoglicate, which mimic allergic processes of the immediate or delayed type. These reactions fulfilled the criteria that characterize pseudo-allergic reactions (3,10). There is a much higher incidence of such adverse reactions when cromoglicate is used orally in the treatment of food allergy, as high as 29% of cases treated (3,10). 

Kallos P, Kallos L. Pseudo-allergic reactions due to sodium cromoglycate. In Dukor P, Kallos P, Schlumberger HD, West GB, editors. Pseudo-allergic Reactions. Involvement of Drugs and Chemicals. Basel Karger, 1982 122-32. 

When injected into the skin, local anesthetics often cause pseudo-allergic reactions, with similar symptoms to immediate type allergy (42). However, true immediate hypersensitivity to local anesthetics is extremely rare. 

Explain the occurrence of pseudo-allergic reactions with opiate administration. 

While there are many studies on the toxicity of colouring agents, there are very few on pharmaceutical flavouring agents. Nevertheless, a variety of allergic or pseudo-allergic reactions have been described, such as hypersentivity reactions, systemic allergic reactions and respiratory depression, as with menthol, for example. 

Dewdney J (1980) Pseudo-allergic reactions to antibiotics. In Dukor P et al. (eds) PAR Pseudo-allergic reactions, vol 1. Karger, Basel, p 273 De Week AL (1964) Penicillin allergy, its detection by an improved hemagglutination technique. Nature 202 975... 

Several different intolerance reactions like urticaria, asthmatic attacks and induction of allergies and pseudo-allergic reaction in humans are known (Tsevat, 1987 Acosta, 1989 Simon, 1993). Sulfites irritate the skin and mucous membranes (Wuthrich, 1993). 

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