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Case Report

 

Anaphylaxis to Oral Iron Salts. Desensitization Protocol for Tolerance Induction

 

M de Barrio, V Fuentes, P Tornero, I Sánchez, J Zubeldia, T Herrero

Allergy Department, Hospital General Universitario “Gregorio Marañón”, Madrid, Spain

J Investig Allergol Clin Immunol 2008; Vol. 18(4): 305-308

 

 Abstract


Allergies to iron salts are seldom reported. We studied a patient with iron-deficiency anemia who had suffered anaphylactic reactions caused by oral iron salts. An allergy study was performed using single-blind, placebo-controlled oral challenge and skin tests with various iron salts as well as excipients in commercial formulations.
Oral challenges were positive for 2 of the commercial formulations of iron salts. Intradermal tests with ferrous sulphate and ferrous lactate also showed positive results. All of the cutaneous tests using the excipients were negative. A desensitization protocol was designed which enabled us to readminister ferrous sulphate, although antihistamines were necessary to guarantee good tolerance to iron salts.
We report a patient with allergy to iron salts, positive skin tests, and positive controlled challenge. We highlight the desensitization protocol designed to complete the therapeutic management of the anemia.

Key words: Oral iron salts. Anaphylaxis. Desensitization.