Titre du document / Document title

Presumed sulfa allergy in patients with intracranial hypertension treated with acetazolamide or furosemide: Cross-reactivity, myth or reality?

Auteur(s) / Author(s)

LEE Andrew G. ^{(1 2 3)} ; ANDERSON Randy ⁽⁴⁾ ; KARDON Randy H. ^{(1 5)} ; WALL Michael ^{(1 5)} ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Ophthalmology at the University of Iowa Hospitals, Iowa City, Iowa, ETATS-UNIS
⁽²⁾ Department of Neurology at the University of Iowa Hospitals, Iowa City, Iowa, ETATS-UNIS
⁽³⁾ Department of Neurosurgery at the University of Iowa Hospitals, Iowa City, Iowa, ETATS-UNIS
⁽⁴⁾ University of Iowa Hospitals anal Clinics, Iowa City, Iowa, ETATS-UNIS
⁽⁵⁾ Veteran's Administration Hospital, Iowa City, Iowa, ETATS-UNIS

Résumé / Abstract

○ PURPOSE: To determine whether acetazolamide or furosemide produce allergic cross-reactions in patients with self-reported sulfa allergy. ○ DESIGN: Retrospective case series. ○ METHODS: A retrospective review included patients with intracranial hypertension and a self-reported sulfa allergy treated with either acetazolamide or furosemide seen at the University of Iowa Hospitals and Clinics from 1972 to 2003. All presumed medication-related side effects were collected, including both predictable adverse effects (for example, paresthesias, fatigue) and unpredictable adverse reactions (for example, cutaneous fixed eruptions, urticaria, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, anaphylaxis). ○ RESULTS: We reviewed 363 charts. Of these, 329 patients (91%) were excluded. Of the remaining 34 cases that did report a so-called sulfa allergy, 13 (38%) received acetazolamide alone, 7 (21%) received furosemide alone, and 14 (41%) received both acetazolamide and furosemide. Of the 27 patients who received acetazolamide, 10 (37%) had no documented allergic cross-reaction to sulfa, and 2 (7%) cases had urticaria. The remaining 15 (56%) of acetazolamide-treated patients experienced predictable adverse reactions for this drug (for example, paresthesias). No patient experienced a severe allergic cross-reaction to sulfa. Of 21 patients who received furosemide, no unpredictable adverse reactions or allergic cross-reactions to sulfa were noted. ○ CONCLUSIONS: We find little clinical or pharmacological evidence to suggest that a self-reported sulfa allergy is likely to produce a life-threatening cross-reaction with acetazolamide or furosemide. These medications should be considered for intracranial hypertension if the risk-to-benefit ratio warrants their use.

Revue / Journal Title

American journal of ophthalmology   ISSN 0002-9394   CODEN AJOPAA 

Source / Source

2004, vol. 138, n^o1, pp. 114-118 [5 page(s) (article)] (25 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1884) (Revue)

Mots-clés anglais / English Keywords

Nervous system diseases ; Central nervous system disease ; Cerebral disorder ; Immunopathology ; Ophthalmology ; Cross reaction ; Furosemide ; Acetazolamide ; Treatment ; Intracranial hypertension ; Patient ; Human ; Allergy ;

Mots-clés français / French Keywords

Système nerveux pathologie ; Système nerveux central pathologie ; Encéphale pathologie ; Immunopathologie ; Ophtalmologie ; Réaction croisée ; Furosémide ; Acétazolamide ; Traitement ; Hypertension intracrânienne ; Malade ; Homme ; Allergie ;

Mots-clés espagnols / Spanish Keywords

Sistema nervioso patología ; Sistema nervosio central patología ; Encéfalo patología ; Inmunopatología ; Oftalmología ; Reacción cruzada ; Furosemida ; Acetazolamida ; Tratamiento ; Hipertensión intracraneal ; Enfermo ; Hombre ; Alergia ;

Localisation / Location

INIST-CNRS, Cote INIST : 2012, 35400011372332.0140