Kidney Res Clin Pract.  2015 Mar;34(1):57-59. 10.1016/j.krcp.2014.09.005.

Immunoglobulin E-mediated hypersensitivity reaction after intraperitoneal administration of vancomycin

• Hwang MJ
• Do JY
• Choi EW
• Seo JH
• Nam YJ
• Yoon KW
• Park JW
• Cho KH
• Kang SH
• Jin HJ

• KMID: 2381515
• DOI: http://doi.org/10.1016/j.krcp.2014.09.005

Abstract

Intraperitoneal (IP) vancomycin is widely used to treat Gram-positive peritonitis associated with peritoneal dialysis. There have been two cases of red man syndrome (RMS), a vancomycin-specific nonimmunologic reaction, associated with IP vancomycin. However, immune-mediated hypersensitivity reaction to IP vancomycin has not yet been reported. A 49 year old woman on continuous ambulatory peritoneal dialysis developed her first peritonitis episode. The patient was treated with IP vancomycin once/wk for 4 weeks. She experienced mild itching and flushing throughout her body for 1 day after the second treatment. Whenever vancomycin was administered, generalized urticaria and a prickling sensation developed, and the intensity increased gradually; however, these symptoms improved after vancomycin was discontinued. An allergic skin test was performed 6 weeks after the previous urticarial episode, and an intradermal skin test revealed a positive response to vancomycin. To our knowledge, this is the first case report of immunoglobulin E-mediated hypersensitivity reaction to IP vancomycin administration.

Keyword

Hypersensitivity; Intraperitoneal administration; Peritoneal dialysis; Vancomycin

MeSH Terms

Female
Flushing
Humans
Hypersensitivity*
Immunoglobulins*
Peritoneal Dialysis
Peritoneal Dialysis, Continuous Ambulatory
Peritonitis
Pruritus
Sensation
Skin Tests
Urticaria
Vancomycin*
Immunoglobulins
Vancomycin