Allergy Asthma Respir Dis.  2018 Sep;6(5):274-276. 10.4168/aard.2018.6.5.274.

Anaphylaxis due to polyethylene glycol: A case report

• Kim TS
• Choi DC
• Lee BJ

• KMID: 2421219
• DOI: http://doi.org/10.4168/aard.2018.6.5.274

Abstract

Polyethylene glycol (PEG) is a major component of bowel preparation solution for colonoscopy. It has been recognized as a safe and effective osmotic laxative that is rarely immunogenic. We here report a case of anaphylaxis due to PEG. A 49-year-old female came to the outpatient clinic wanting to find the cause of skin rash, nausea and respiratory difficulty after ingesting bowel evacuant solution (Clicool). She had visited local Emergency Department at the time of event and was diagnosed with anaphylaxis. We performed skin tests with components of Clicool to identify the cause of anaphylactic reactions. The result showed a positive skin response only to PEG. In contrast, skin test done in the control showed no reactions to PEG. This is the first case that revealed PEG to be an exact cause of anaphylaxis after ingesting a bowel evacuant.

Keyword

Anaphylaxis; Polyethylene glycol; Bowel preparation solution

MeSH Terms

Ambulatory Care Facilities
Anaphylaxis*
Colonoscopy
Emergency Service, Hospital
Exanthema
Female
Humans
Middle Aged
Nausea
Polyethylene Glycols*
Polyethylene*
Skin
Skin Tests
Polyethylene
Polyethylene Glycols

Figure

• 

  Fig. 1 Results of skin prick test of the patient. Sodium ascorbate (shown as ‘A’), sodium chloride (shown as ‘Cl’), and sodium sulfate (shown as ‘S’) showed no skin reaction in all concentrations (0.05 mg/mL → 0.5 mg/mL → 5 mg/mL). However, polyethylene glycol (shown as ‘P’) showed skin reaction of 2×2 mm wheal (2+) in 1 mg/mL, 4×4 mm wheal (3+) in 10 mg/mL, and 4×4 mm wheal (3+) in 100 mg/mL. Histamine (shown as ‘+’) was used for positive control, while normal saline (shown as ‘−’) was used for negative control.

• 

  Fig. 2 Results of skin prick test of the control. Histamine (shown as ‘+’) was used for positive control. No skin reaction was observed in all concentrations of polyethylene glycol (shown as ‘P’, 1 mg/mL → 10 mg/mL → 100 mg/mL).

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