Clinical manifestations and impact on daily life of allergy to polyethylene glycol (PEG) in ten patients
Clinical manifestations and impact on daily life of allergy to polyethylene glycol (PEG) in ten patients
复制标题
DOI：
10.1111/cea.13822
复制
发表时间：
2021-01-15
影响因子：
6.1
通讯作者：
Garvey, Lene H.
中科院分区：
文献类型：
--
作者：
Bruusgaard-Mouritsen, Maria A.;Johansen, Jeanne D.;Garvey, Lene H.
背景：聚乙二醇（PEG）被广泛用作药物、化妆品和家用产品的辅料。包括速发型过敏反应在内的PEG速发型过敏反应是罕见的。最近推出的基于mRNA的COVID-19疫苗导致人们越来越关注PEG作为疫苗过敏反应的可能罪魁祸首。消费者、制造商和医生对PEG的潜在致敏性认识不足，导致对PEG过敏的诊断不足和报告不足，使患者面临反复严重反应的风险。目的：调查2010年至2019年诊断为PEG过敏的患者的临床表现、诊断时间以及PEG过敏诊断对日常生活的影响。方法：纳入了10例诊断为PEG过敏的患者。获得了详细的临床病史，并在诊断时进行了过敏调查。所有的患者进行了联系，并要求回顾性地完成一份问卷调查的原因和影响的日常生活中的过敏PEG，评分的likert规模（0-10）之前和之后diagnosis.Results：8例患者经历了至少一个过敏反应，需要肾上腺素治疗。过敏反应主要由抗生素/止痛片、贮库类固醇、抗酸剂和泻药引起。7例患者在诊断前报告了重复反应（中位数3，范围2-6）。从首次反应到诊断的中位时间为20个月（范围2-120）。所有患者在诊断后均未发生严重过敏反应。诊断前对日常生活影响的中位Likert评分为7分，诊断后为4分。结论和临床相关性：PEG过敏的临床表现往往是戏剧性的。需要提高对临床表现和常见病因的认识，明确产品标签和标准化术语，以确保及时诊断PEG过敏，防止严重影响患者生命的反复过敏反应。
Background: Polyethylene glycols (PEGs) are widely used as excipients in drugs, cosmetics and household products. Immediate-type allergy to PEGs including anaphylaxis is rare. The recent introduction of the mRNA-based COVID-19 vaccines has led to an increased focus on PEG as a possible culprit of allergic reactions to the vaccines. A low awareness of the allergenic potential of PEG among consumers, manufacturers and doctors leads to under-diagnosis and under-reporting of allergy to PEGs, putting patients at risk of repeated severe reactions.Objectives: To investigate clinical manifestations, time to diagnosis and impact of a PEG allergy diagnosis on the daily life of patients diagnosed with allergy to PEG from 2010 to 2019.Method: Ten patients diagnosed with allergy to PEG were included. Detailed clinical history was obtained, and allergy investigations had been performed at the time of diagnosis. All patients were contacted and asked to retrospectively complete a questionnaire about causes and impact on daily life of an allergy to PEG, scored on a likert scale (0-10) before and after diagnosis.Results: Eight patients had experienced at least one anaphylactic reaction requiring adrenaline treatment. Anaphylaxis was primarily caused by antibiotic/analgesic tablets, depot-steroids, antacids and laxatives. Seven patients reported repeated reactions before diagnosis (median 3, range 2-6). Median time from first reaction to diagnosis was 20 months (range 2-120). None of the patients experienced severe allergic reactions after the diagnosis. Median likert score of the impact on daily life before diagnosis was 7 compared with 4 after diagnosis.Conclusion and clinical relevance: The clinical manifestations of PEG allergy are often dramatic. Improved awareness about the clinical presentation and common culprits, clear product labelling and a standardized nomenclature is needed to ensure the timely diagnosis of PEG allergy to prevent repeated anaphylactic reactions with severe impact on patients' lives.