Allergy Asthma Respir Dis.  2015 Jul;3(4):307-309. 10.4168/aard.2015.3.4.307.

Immediate hypersensitivity reaction to polyethylene glycol 3350

Affiliations
  • 1Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea. helenmed@snu.ac.kr
  • 2Respirology and Allergy Clinic, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 3Regional Pharmacovigilance Center, Seoul National University Hospital, Seoul, Korea.
  • 4Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 5Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
  • 6Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

Abstract

Polyethylene glycol (PEG) 3350 is the main ingredient of oral solutions for bowel preparation prior to colonoscopy. This high-molecular-weight PEG has shown a low incidence of adverse reactions because of its low absorption via the intestine. Systemic allergic reactions to PEG solution are very rare, and only 10 cases have been reported in the literature worldwide. We experienced a case of immediate hypersensitivity reaction to PEG 3350. A 35-year-old male patient was prescribed PEG 3350 solution for colonoscopy. After ingestion of 2.5 pack (55 g of PEG 3350 powder), he began to show urticaria on both arms and trunk, and swelling in the lips. Symptoms resolved over the next few hours without any treatment. Skin prick and intradermal tests with PEG 3350 showed positive responses to both test. We also performed oral provocation tests with PEG 3350. Thirty minutes after ingestion of 2.5 g of PEG 3350 powder, the patient presented with mild urticaria and angioedema. Finally he was diagnosed with immediate hypersensitivity reaction by PEG 3350. The patient underwent colonoscopy after preparation with sodium phosphate solution without any adverse reactions. We herein report the first case of PEG 3350-induced immediate hypersensitivity reaction confirmed by skin and oral provocation tests in Korea.

Keyword

Immediate hypersensitivity; Polyethylene glycols; Skin tests

MeSH Terms

Absorption
Adult
Angioedema
Arm
Colonoscopy
Eating
Humans
Hypersensitivity
Hypersensitivity, Immediate*
Incidence
Intestines
Intradermal Tests
Korea
Lip
Male
Polyethylene Glycols*
Polyethylene*
Skin
Skin Tests
Sodium
Urticaria
Polyethylene
Polyethylene Glycols
Sodium

Figure

  • Fig. 1 Photos of skin tests using polyethylene glycol (PEG) 3350. Positive responses were observed in prick test (A) and intradermal test (B). H, histamine; S, saline.


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