Immediate-type hypersensitivity reaction to Mannitol as drug excipient (E421): a case report

G F Calogiuri; L Muratore; E Nettis; A M Casto; E Di Leo; A Vacca

Immediate-type hypersensitivity reaction to Mannitol as drug excipient (E421): a case report

Eur Ann Allergy Clin Immunol. 2015 May;47(3):99-102.

Authors

G F Calogiuri¹, L Muratore², E Nettis³, A M Casto², E Di Leo³, A Vacca⁴

Affiliations

¹ Pneumology Department, Hospital Ninetto Melli, San Pietro Vernotico, Brindisi, Italy. Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy. E-mail: gf.calogiuri@libero.it.
² Allergy and Clinical Immunology Center, Civil Hospital Vito Fazzi, Lecce, Italy.
³ Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy.
⁴ Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy. Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy.

PMID: 25951149

Abstract

Allergic reactions to mannitol have been reported rarely, despite its widespread use as a drug and as a food excipient. This is the first case report in which oral mannitol induces an immediate type hypersensitivity as a drug excipient, in a 42 year old man affected by rhinitis to olive tree pollen. Unusual and undervalued risk factors for mannitol hypersensitivity are examined.

Keywords: Excipient; Mannitol; Olive tree pollen; Oral challenge test; Paracetamol; Rhinitis; Urticaria.

Publication types

Case Reports

MeSH terms

Administration, Oral
Adrenal Cortex Hormones / therapeutic use
Adult
Drug Hypersensitivity / diagnosis
Drug Hypersensitivity / drug therapy
Drug Hypersensitivity / etiology*
Excipients / administration & dosage
Excipients / adverse effects*
Histamine Antagonists / therapeutic use
Humans
Hypersensitivity, Immediate / diagnosis
Hypersensitivity, Immediate / drug therapy
Hypersensitivity, Immediate / etiology*
Immunologic Tests
Male
Mannitol / administration & dosage
Mannitol / adverse effects*
Predictive Value of Tests
Risk Factors
Treatment Outcome

Substances

Adrenal Cortex Hormones
Excipients
Histamine Antagonists
Mannitol