Abstract | BACKGROUND: CASE PRESENTATION: Here, we describe a young man with hazelnut and birch pollen allergy, who experienced exercise-induced anaphylaxis after isotretinoin intake on the third day of treatment. A complete allergy work-up was carried out, and sensitization to both peanut and soybean PR10-proteins was confirmed. However, oral provocation with isotretinoin remained negative in the absence of intense physical activity and longterm treatment was well tolerated. CONCLUSION: To our knowledge, this is the first report of an exercise-induced anaphylaxis due to isotretinoin therapy. Our literature review to assess tolerability of isotretinoin in patients allergic to peanut, tree nuts or soybean revealed only one other case of anaphylaxis in a cashew-nut allergic patient sensitized to soybean PR10-protein Gly m 4. While there are no reports on soybean allergic patients treated with isotretinoin, the vast majority of peanut or tree nut allergic patients tolerated isotretinoin. Therefore, we conclude that sensitization to soybean, peanut or tree nuts should not preclude isotretinoin therapy. Particular caution is however warranted in patients with soybean sensitization. Pre-treatment oral challenges with isotretinoin may be recommended and physicians should be aware of the potential role of cofactors.
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Authors | Anna Bamidis, Silke C Hofmann |
Journal | Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology
(Allergy Asthma Clin Immunol)
Vol. 17
Issue 1
Pg. 101
(Oct 09 2021)
ISSN: 1710-1484 [Print] England |
PMID | 34627369
(Publication Type: Journal Article)
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Copyright | © 2021. The Author(s). |