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정제 알약 내 미량의 포비돈이 원인으로 추정되는 아나필락시스 1예

A case of anaphylaxis presumably caused by a trace amount of povidone in a tablet pill

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주제분류소아과학

초록

Povidone, also known as polyvinylpyrrolidone has high sterilizing power and low toxicity, and has been widely used in disinfectants, ointments, gels, shampoos, soap, and pharmaceutical tablet additives. Povidone‐iodine (Betadine) is a rare cause of IgE‐mediated allergy, and to our best of knowledge there have been no reports in Korea. We report the first case of anaphylaxis in Korea presumably caused by a trace amount of povidone contained in a tablet pill. An 18-year-old man experienced severe rhinorrhea, nasal congestion, eyelid swelling, cough, and dyspnea after taking multiple drugs at the same time for abdominal pain and diarrhea 20 days before the hospital visit. Symptoms disappeared after the treatment. He experienced similar symptoms after applying povidone to skin wounds 2 years ago. Among the drugs taken, these symptoms were assumed to be caused by a drug containing a trace amount of povidone. The remaining drug was tested by oral provocation, and there were no adverse reactions. He has avoided drugs containing povidone and has not experienced similar reactions for more than 1 year since then. Therefore, it is presumed that a systemic hypersensitivity reaction may occur due to a very small amount of povidone in a tablet pill.

Abstract

Povidone, also known as polyvinylpyrrolidone has high sterilizing power and low toxicity, and has been widely used in disinfectants, ointments, gels, shampoos, soap, and pharmaceutical tablet additives. Povidone‐iodine (Betadine) is a rare cause of IgE‐mediated allergy, and to our best of knowledge there have been no reports in Korea. We report the first case of anaphylaxis in Korea presumably caused by a trace amount of povidone contained in a tablet pill. An 18-year-old man experienced severe rhinorrhea, nasal congestion, eyelid swelling, cough, and dyspnea after taking multiple drugs at the same time for abdominal pain and diarrhea 20 days before the hospital visit. Symptoms disappeared after the treatment. He experienced similar symptoms after applying povidone to skin wounds 2 years ago. Among the drugs taken, these symptoms were assumed to be caused by a drug containing a trace amount of povidone. The remaining drug was tested by oral provocation, and there were no adverse reactions. He has avoided drugs containing povidone and has not experienced similar reactions for more than 1 year since then. Therefore, it is presumed that a systemic hypersensitivity reaction may occur due to a very small amount of povidone in a tablet pill.

참고문헌 (18)

  1. Lee CH, "A case of allergic contact dermatitis to antiseptics", Korean J Dermatol, 37, pp.966~ (1999)
  2. Yoo SH, "Two cases of allergic contact dermatitis to povidone-iodine", Korean J Dermatol, 37, pp.691~ (1999)
  3. Fowler Jr JF, "Allergic contact dermatitis to polyvinylpyrrolidone", hexadecene copolymer, 1995, pp.6, 243~244
  4. Le Pabic F, "First case of anaphylaxis to iodinated povidone", Allergy, 58, pp.826~827 (2003)
  5. Rönnau A, "Anaphylaxis to polyvinylpyrrolidone in an analgesic preparation", Br J Dermatol, 143, pp.1055~1058 (2000)
  6. Adachi A, "Anaphylaxis to polyvinylpyrrolidone after vaginal application of povidone-iodine", Contact Dermatitis, 48, pp.133~136 (2003)
  7. Garijo MAG, "Anaphylactic shock following povidone", Ann Pharmacother, 30, pp.37~40 (1996)
  8. Ring J, "Idiopathic anaphylaxis", Curr Allergy Asthma Rep, 2, pp.40~45 (2002)
  9. 송우정, "Two Cases of H2-Receptor Antagonist Hypersensitivity and Cross-Reactivity", Allergy, Asthma & Immunology Research, 3(2), pp.128~131 (2011), 대한천식알레르기학회
  10. Simons FER, "World allergy organization guidelines for the assessment and management of anaphylaxis", World Allergy Organ J, 4, pp.13~37 (2011)
  11. 양민석, "약물알레르기 검사의 시행과 해석: 전문가 의견서", Allergy Asthma & Respiratory Disease, 5(5), pp.239~247 (2017), 대한 소아알레르기 호흡기학회[DOI]
  12. Won HK, "Determination of nonirritating concentrations of antibiotics for intradermal skin tests in Korean adults", J Allergy Clin Immunol Pract, 5, pp.192~194 (2017)
  13. Bosso JV, "Food allergy: adverse reactions to foods and food additives", pp.340~ (2008), Blackwell
  14. Zimecki M, "The influence of molecular weight on immuno genicity and suppressor cells in the immune response to polyvinylpyrollidone", Clin Immunol Immunopathol, 9, pp.75~79 (1978)
  15. Nair B, "Final report on the safety assessment of polyvinylpyrrolidone(PVP)", Int J Toxicol, 17, pp.95~130 (1998)
  16. Haaf F, "Polymers of N-vinylpyrrolidone : synthesis, characterization and uses", Polymer J, 17, pp.143~152 (1985)
  17. Bühler V, "Polyvinylpyrrolidone excipients for pharmaceuticals: povidone, crospovidone and copovidone" (2005), Springer-Verlag Berlin Heidelberg
  18. Cameron A, "Blood plasma expander-PVP", Delaware Med J, 26, pp.149~ (1954)

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