methylcellulose and Drug-Hypersensitivity

We report a case of immediate severe anaphylaxis to hydroxypropyl methylcellulose (HPMC) on 2 separate occasions during cataract surgery in a 71-year-old patient. Skin prick tests were positive for HPMC, a constituent of Ocucoat and Xylocaine gel, which were administered intraocularly during surgery. Skin prick tests were also positive for methylcellulose. Based on symptoms and clinical signs of anaphylaxis following 2 separate cataract operations together with positive prick tests to HPMC, HPMC is the most plausible cause of the reactions. The patient has since had uneventful surgery for a detached retina avoiding HPMC. This case stresses the importance of considering all medication given to patients as possible causes of an anaphylactic reaction.. No author has a financial or proprietary interest in any material or method mentioned.

Topics: Aged; Anaphylaxis; Cataract Extraction; Drug Hypersensitivity; Humans; Hypromellose Derivatives; Male; Methylcellulose; Ophthalmic Solutions; Recurrence; Skin Tests

Cattle were more readily sensitised than guinea pigs to carboxymethylcellulose. Freund's complete adjuvant enhanced, but was not essential for, sensitisation. Schultz-Dale responses were obtained from pulmonary tissues of sensitised cattle but their sera failed to induce passive cutaneous anaphylaxis. Cattle could possibly be sensitised by carboxymethylcellulose contained in drug formulations.

Topics: Anaphylaxis; Animals; Antigens; Bordetella pertussis; Carboxymethylcellulose Sodium; Cattle; Cattle Diseases; Drug Hypersensitivity; Freund's Adjuvant; Guinea Pigs; Histamine Release; Injections, Intradermal; Injections, Intramuscular; Injections, Intraperitoneal; Injections, Intravenous; Methylcellulose; Muscle Contraction; Ovalbumin; Passive Cutaneous Anaphylaxis

Intravenous provocation (IVP) tests demonstrated that hydroxypropylmethylcellulose (MC) was able to elicit anaphylactic signs in cattle vaccinated with foot-and-mouth disease (FMD) vaccine produced at one centre but not with similar vaccine produced at another. The former vaccine also provoked serum reagins which were demonstrated by passive cutaneous anaphylaxis (PCA) tests in goats. Reaginic sera which reacted specifically with MC were used in PCA tests to screen samples taken serially from the vaccine production lines. The reactions observed suggested that a substance with MC or similar specificity was present in the antifoaming agent routinely added to vaccines.

Topics: Amino Acids; Anaphylaxis; Animals; Cattle; Culture Media; Drug Hypersensitivity; Female; Foot-and-Mouth Disease; Goats; Hypersensitivity; Injections, Intradermal; Injections, Subcutaneous; Male; Methylcellulose; Neomycin; Passive Cutaneous Anaphylaxis; Polymyxins; Vaccination; Viral Vaccines

Topics: Adult; Ceramics; Cosmetics; Drug Hypersensitivity; Drug Industry; Food Preservation; Humans; Hypersensitivity, Immediate; Injections, Intradermal; Male; Methylcellulose; Skin Tests; Suspensions; Triamcinolone Acetonide; Urticaria

Topics: Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Drug Hypersensitivity; Glycols; Methylcellulose; Polyethylenes; Vaccination

Topics: Adrenocorticotropic Hormone; Animals; Antibody Formation; Drug Hypersensitivity; Humans; Iodine Isotopes; Methylcellulose; Pharmaceutical Vehicles; Swine

Topics: Anaphylaxis; Animals; Cattle; Cattle Diseases; Drug Hypersensitivity; Guinea Pigs; Methylcellulose; Penicillins; Skin Tests