Immunoglobulin E-mediated hypersensitivity reaction after intraperitoneal administration of vancomycin

Publication date: Available online 5 December 2014 Source:Kidney Research and Clinical Practice Author(s): Mun-Ju Hwang , Jun-Young Do , Eun-Woo Choi , Joon-Hyuk Seo , Yoon-Jung Nam , Kyung-Woo Yoon , Jong-Won Park , Kyu-Hyang Cho , Seok-Hui Kang , Hyun-Jung Jin Intraperitoneal (IP) vancomycin is widely used to treat Gram-positive peritonitis associated with peritoneal dialysis. There have been two cases of red man syndrome (RMS), a vancomycin-specific nonimmunologic reaction, associated with IP vancomycin. However, immune-mediated hypersensitivity reaction to IP vancomycin has not yet been reported. A 49 year old woman on continuous ambulatory peritoneal dialysis developed her first peritonitis episode. The patient was treated with IP vancomycin once/wk for 4 weeks. She experienced mild itching and flushing throughout her body for 1 day after the second treatment. Whenever vancomycin was administered, generalized urticaria and a prickling sensation developed, and the intensity increased gradually; however, these symptoms improved after vancomycin was discontinued. An allergic skin test was performed 6 weeks after the previous urticarial episode, and an intradermal skin test revealed a positive response to vancomycin. To our knowledge, this is the first case report of immunoglobulin E-mediated hypersensitivity reaction to IP vancomycin administration.
Source: Kidney Research and Clinical Practice - Category: Urology & Nephrology Source Type: research