povidone-iodine and Food-Hypersensitivity

"Iodine allergy" does not exist. The concept of "iodine allergy" should be abandoned since it may result in inappropriate measures such as drug, food or environmental eviction. Immediate or non-immediate allergic hypersensitivity to iodinated contrast media is not infrequent. The corresponding allergens have not been identified. Iodine is not involved. Immediate or non-immediate allergic hypersensitivity to povidone iodine is rare. The corresponding allergen is povidone in case of immediate hypersensitivity while nonoxynol might be involved during non-immediate hypersensitivity. Seafood allergens belong to a group of muscle proteins. Immediate drug hypersensitivity or food hypersensitivity is assessed by immediate-reading skin tests while non-immediate drug hypersensitivity is investigated by delayed-reading skin testing. Combined histamine and tryptase measurement is invaluable during the diagnostic approach of immediate hypersensitivity. Other biological tests are being evaluated. Allergic hypersensitivity to iodinated contrast agents does not contraindicate the use of other iodinated drugs.

Topics: Allergens; Amiodarone; Anaphylaxis; Animals; Anti-Infective Agents, Local; Biomarkers; Contrast Media; Dermatitis, Contact; Dietary Proteins; Drug Hypersensitivity; Food Hypersensitivity; Histamine Release; Humans; Hypersensitivity, Immediate; Iodine; Iodine Compounds; Muscle Proteins; Potassium Iodide; Povidone-Iodine; Seafood; Skin Tests; Thyroxine; Tryptases

Anaphylaxis during anaesthesia is a rare event which is mainly related to neuromuscular blocking agents. Latex and antibiotics are less frequently incriminated. However, allergy may be triggered by other less frequent and hidden allergen. Among these, povidone is largely used in numerous therapeutics and cosmetics. We report here an exceptional case of grade 3 anaphylactic shock with iodinated povidone administered via a rectal route.

Topics: Administration, Rectal; Anaphylaxis; Anti-Infective Agents, Local; Colectomy; Colonic Diseases; Combined Modality Therapy; Crystalloid Solutions; Diagnostic Errors; Drug Hypersensitivity; Epinephrine; Food Hypersensitivity; Humans; Intestinal Perforation; Isotonic Solutions; Male; Methylprednisolone; Middle Aged; Povidone-Iodine; Preanesthetic Medication; Shock, Septic; Wernicke Encephalopathy