Immediate Hypersensitivity Reaction to Pheniramine in a Case of Multiple Drug Hypersensitivity Syndrome.

Publication date: Feb 01, 2025

Multiple drug hypersensitivity syndrome (MDHS) is a rare condition characterized by hypersensitivity reactions to at least two chemically unrelated drugs. While non-steroidal anti-inflammatory drugs and antibiotics are the most commonly implicated agents, hypersensitivity to antihistamines is extremely rare. A comprehensive approach, including detailed patient history, skin testing, and drug provocation tests, is essential for the accurate diagnosis and management of MDHS, particularly in patients with multiple drug reactions. When evaluating MDHS, antihistamines should also be considered as potential culprits if suggested by the patient’s history. Here, we aimed to present a case of a patient who reported allergic reactions following the administration of diclofenac sodium, paracetamol, COVID-19 mRNA vaccine, clarithromycin, and pheniramine hydrogen maleate. Based on the skin and provocation tests we performed, the patient was diagnosed with multiple drug hypersensitivity along with pheniramine allergy.

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Concepts Keywords
19mrna anaphylaxis
Antibiotics chronic urticaria
Covid immediate type reaction
Drugs pheniramine hydrogen maleate
Rare

Semantics

Type Source Name
disease MESH Immediate Hypersensitivity
drug DRUGBANK Pheniramine
disease MESH Drug Hypersensitivity Syndrome
disease MESH hypersensitivity
disease IDO history
drug DRUGBANK Acetaminophen
drug DRUGBANK Clarithromycin
disease MESH drug hypersensitivity
pathway REACTOME Reproduction
drug DRUGBANK Coenzyme M
disease MESH COVID 19
disease MESH Emergency
disease MESH anaphylaxis
disease MESH chronic urticaria
disease MESH syndrome
disease IDO entity
disease MESH adverse drug reactions
disease MESH urticaria
disease MESH angioedema
disease MESH Stevens Johnson syndrome
disease MESH serum sickness
disease MESH cytopenias
disease MESH insomnia
disease MESH viral infections
drug DRUGBANK Histamine
drug DRUGBANK Chlorphenamine
drug DRUGBANK Brompheniramine
drug DRUGBANK Dexchlorpheniramine
disease MESH erythema
disease MESH dyspnea
drug DRUGBANK Celecoxib
disease IDO blood
drug DRUGBANK Dirithromycin
disease MESH edema
disease MESH hypotension
disease MESH hypoxia
drug DRUGBANK Methylprednisolone
drug DRUGBANK Cetirizine
disease IDO symptom
disease MESH causality
drug DRUGBANK Gold
drug DRUGBANK Piperazine
drug DRUGBANK Diphenhydramine
drug DRUGBANK Loratadine
disease MESH drug eruption
drug DRUGBANK Bismuth subgallate
disease MESH Asthma
pathway KEGG Asthma

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