Laryngeal edema and anaphalactic shock after topical propolis use for acute pharyngitis

Propolis is believed to have pharmacological effect at low dose, and may result in an adverse allergy effect at a dose over 15 g/day.7 In the recent decades, it is well known by the dermatologist that occupational contact dermatitis and ulcerative gingivitis are the major manifestations of propolis...

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Bibliographic Details
Published in:The American journal of emergency medicine 2004-09, Vol.22 (5), p.432-433
Main Authors: Hsu, Chiung-Yuan, Chiang, Wen-Chu, Weng, Te-I, Chen, Wen-Jone, Yuan, Ang
Format: Article
Language:English
Subjects:
Acute Disease
Administration, Topical
Airway management
Allergies
Anaphylaxis
Anaphylaxis - chemically induced
Anaphylaxis - diagnosis
Anaphylaxis - therapy
Anti-Infective Agents - adverse effects
Contact dermatitis
Edema
Emergency medical care
Emergency Medical Services - methods
Emergency Treatment - methods
Fatal Outcome
Heart Arrest - chemically induced
Humans
Hypoxia
Intubation
Laryngeal Edema - chemically induced
Laryngeal Edema - diagnosis
Laryngeal Edema - therapy
Male
Middle Aged
Pharyngitis - drug therapy
Propolis - adverse effects
Respiratory distress syndrome
Seizures - chemically induced
Side effects
Tomography, X-Ray Computed
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Summary:Propolis is believed to have pharmacological effect at low dose, and may result in an adverse allergy effect at a dose over 15 g/day.7 In the recent decades, it is well known by the dermatologist that occupational contact dermatitis and ulcerative gingivitis are the major manifestations of propolis allergy.8,9 Callejo et al reported an event of honeybee sting-induced immediate anaphylaxis reaction in a patient of chronic occupational exposure to beehive products including propolis.10 In vivo and in vitro study of this patient revealed IgE-mediated reaction to propolis should be responsible to this adverse reaction.10 Other studies revealed the major allergen in propolis is "LB-1,"11 which consists of 3 isomeric pentenyl caffeates but phenylethyl caffeate is as strong a sensitizer as the "LB-1" whereas benzyl salicylate is a moderate sensitizer.12 In our case, although the time sequence of this patient's symptoms did not immediately occur after the second propolis use in his life, severe angioedema and anaphylaxis were the main clinical manifestation and IgE-mediated allergic reaction may play the main mechanism of this severe adverse reaction.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2004.06.007