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A case of progesterone-induced anaphylaxis, cyclic urticaria/angioedema, and autoimmune dermatitis.
- Source :
-
Journal of women's health (2002) [J Womens Health (Larchmt)] 2011 Apr; Vol. 20 (4), pp. 643-8. Date of Electronic Publication: 2011 Mar 18. - Publication Year :
- 2011
-
Abstract
- Objective: Women have exhibited anaphylaxis, urticaria/angioedema, and autoimmune progesterone dermatitis (APD) coinciding with the progesterone premenstrual rise. We report a detailed immunological evaluation of such a woman responsive to a gonadotropin hormone-releasing agonist (GHRA).<br />Methods: Skin testing, enzyme-linked immunosorbent assays (ELISAs), leukocyte histamine release (LHR), and inhibition assays were performed to demonstrate progesterone immunoresponsiveness.<br />Results: Serum specific-progesterone immunoglobulin G (IgG) and IgE were detected initially and disappeared 6 months after GHRA treatment. Dose-response LHR using patient basophils was observed for different hormones but after 3 months persisted only for 5β-pregnanediol. Preincubation with mouse antiprogesterone monoclonal antibody (PmAb) or mifepristone, a progesterone inhibitor, over a range of doses inhibited specific progesterone-induced LHR. Experiments with varying progesterone concentrations and a fixed dose of anti-IgE resulted in 100% LHR at a concentration as low as 0.016 nmol/mL, which, without anti-IgE, failed to release histamine.<br />Conclusions: This is the first report of combined recurrent anaphylaxis, cyclic urticaria/angioedema, and APD induced by immunoresponsiveness to progesterone.
- Subjects :
- Anaphylaxis drug therapy
Angioedema
Animals
Antibodies, Monoclonal, Murine-Derived therapeutic use
Autoimmune Diseases chemically induced
Contraceptives, Oral, Combined administration & dosage
Contraceptives, Oral, Combined adverse effects
Contraceptives, Oral, Synthetic administration & dosage
Dermatitis
Drug Eruptions
Enzyme-Linked Immunosorbent Assay
Estrogens administration & dosage
Ethinyl Estradiol administration & dosage
Female
Fertility Agents, Female therapeutic use
Gonadotropin-Releasing Hormone therapeutic use
Hormone Antagonists therapeutic use
Humans
Immunoglobulin E immunology
Immunoglobulin G immunology
Mice
Middle Aged
Mifepristone therapeutic use
Nafarelin therapeutic use
Norethindrone administration & dosage
Progesterone therapeutic use
Urticaria chemically induced
Anaphylaxis chemically induced
Contraceptives, Oral, Synthetic adverse effects
Estrogens adverse effects
Ethinyl Estradiol adverse effects
Norethindrone adverse effects
Progesterone adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1931-843X
- Volume :
- 20
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of women's health (2002)
- Publication Type :
- Academic Journal
- Accession number :
- 21417747
- Full Text :
- https://doi.org/10.1089/jwh.2010.2468