BACKGROUND: Sodium carboxymethylcellulose (SCMC) is the sodium salt of a polycarboxymethyl ether of cellulose. SCMC is widely used in pharmaceutical and food industries. We present the case of a 47-year-old man who suffered an anaphylactic shock after an intra-articular injection of Trigon depot. METHODS AND RESULTS: Prick and intradermal tests with Trigon depot and its components (triamcinolone acetonide, Tween 80, benzylalcohol, SCMC), mepivacaine 2% and latex were performed. Challenge test with mepivacaine 2% was also realized. RESULTS: Showed a positive intradermal test to Trigon depot and carboxymethylcellulose, with negative results to the rest (including challenge test to mepivcaine 2%). CONCLUSIONS: Our results support the diagnosis of anaphylactic shock after intra-articular injection of carboxymethylcellulose and we consider necessary to emphasize that excipients must be taken into account as a potential source of adverse reactions to drugs.
BACKGROUND:Sodium carboxymethylcellulose (SCMC) is the sodium salt of a polycarboxymethyl ether of cellulose. SCMC is widely used in pharmaceutical and food industries. We present the case of a 47-year-old man who suffered an anaphylactic shock after an intra-articular injection of Trigon depot. METHODS AND RESULTS: Prick and intradermal tests with Trigon depot and its components (triamcinolone acetonide, Tween 80, benzylalcohol, SCMC), mepivacaine 2% and latex were performed. Challenge test with mepivacaine 2% was also realized. RESULTS: Showed a positive intradermal test to Trigon depot and carboxymethylcellulose, with negative results to the rest (including challenge test to mepivcaine 2%). CONCLUSIONS: Our results support the diagnosis of anaphylactic shock after intra-articular injection of carboxymethylcellulose and we consider necessary to emphasize that excipients must be taken into account as a potential source of adverse reactions to drugs.
Authors: Maria Luisa Caballero; Matthew S Krantz; Santiago Quirce; Elizabeth J Phillips; Cosby A Stone Journal: J Allergy Clin Immunol Pract Date: 2021-03-15