Immediate hypersensitivity reaction followed by successful oral desensitization to ursodiol

Erika Yue Lee; Christine Song

doi:10.1186/s13223-021-00578-7

Immediate hypersensitivity reaction followed by successful oral desensitization to ursodiol

Allergy Asthma Clin Immunol. 2021 Jul 22;17(1):75. doi: 10.1186/s13223-021-00578-7.

Authors

Erika Yue Lee^{1

2}, Christine Song^{3

4}

Affiliations

¹ Department of Medicine, University of Toronto, Toronto, ON, Canada. erika.lee@mail.utoronto.ca.
² Division of Clinical Allergy and Immunology, Department of Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. erika.lee@mail.utoronto.ca.
³ Department of Medicine, University of Toronto, Toronto, ON, Canada.
⁴ Division of Clinical Allergy and Immunology, Department of Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.

Abstract

Background: Immediate hypersensitivity reaction to ursodiol is rare and there is no previously published protocol on ursodiol desensitization.

Case presentation: A 59-year-old woman with primary biliary cholangitis (PBC) developed an immediate hypersensitivity reaction to ursodiol-the first-line treatment for PBC. When she switched to a second-line treatment, her PBC continued to progress. As such, she completed a novel 12-step desensitization protocol to oral ursodiol. She experienced recurrent pruritus after each dose following desensitization, which subsided after a month of being on daily ursodiol.

Conclusion: Immediate hypersensitivity reaction to ursodiol is uncommon. Our case demonstrated that this novel desensitization protocol to ursodiol could be safely implemented when alternative options are not available or have proven inferior in efficacy.

Keywords: Desensitization; Immediate drug hypersensitivity; Primary biliary cholangitis; Ursodeoxycholic acid; Ursodiol.