Intolerance reactionK90.4; T88.7
Synonym(s)
Pseudoallergic reaction; Pseudoallergy; Pseudo-Allergy; Reaction pseudoallergic
DefinitionThis section has been translated automatically.
Acute or chronic, non-immunological, dose-dependent, biological reaction form that mimics an allergic reaction and has no relation to pharmacological toxicity in the case of triggering drugs. Enzymatically triggered reactions such as lactose intolerance or ACE-induced angioedema are also considered intolerance reactions.
Frequently triggered by drugs, e.g. salicylates ( urticaria, intolerance urticaria), food preservatives and dyes or biogenic amines (see also immunological drug reactions).
EtiopathogenesisThis section has been translated automatically.
Mechanisms and causes of intolerance reactions:
- Mediator release from mast cells: tartrazine (?), antibiotics, muscle relaxants, opioids.
- Influence on the metabolism of arachidonic acid: X-ray contrast media, analgesics (e.g. salicylates), anti-inflammatory drugs, food dyes (?), benzoates(?), parabens (?).
- Complement activation: immunoglobulin aggregates, X-ray contrast agent, protamine.
- Kinin activation: local anesthetics, ACE inhibitors.
- Lymphocyte activation: ampicillin, hydantoin.
- Release of neurotransmitters: erythrosine, glutamate.
- Excitation of autonomic receptors: sulphites, glutamate, local anaesthetics
- Activation of the MRGPRX2 receptor (plays a role in the intolerance reaction to ciprofloxacin)
Clinical featuresThis section has been translated automatically.
Possible symptoms include chronic urticaria, anaphylactic shock, angioedema, gastrointestinal complaints and respiratory tract symptoms ranging from rhinitis to asthma attacks.
LiteratureThis section has been translated automatically.
- Ring J et al (2018) Immediate type allergy: Rhinoconjunctivitis, bronchial asthma, anaphylaxis. In: Braun-Falco`s Dermatology, Venerology Allergology G. Plewig et al. (Hrsg) Springer Verlag S 454