RIT with IFA WBE for IFA hypersensitivity is both safe and efficacious; the rate of mild systemic reactions is low. Premedication is not necessary, inasmuch as prophylactic pretreatment with antihistamines and steroids did not reduce the systemic reaction rate associated with RIT.
Anaphylaxis is rare with opiates. A local cutaneous reaction may occur with the intravenous infusion of meperidine and should not be confused with a systemic reaction. We present a case of a local urticarial reaction associated with the intravenous infusion of meperidine in a patient with sickle cell disease. No systemic manifestations occurred and the reaction re¬ solved with the administration of an antihistamine. Localized cutaneous reactions have been reported previously with the intravenous infusion of meperidine. Rarely, a large urticarial response may occur at the infusion site resulting from direct mast cell release by the drug. A large, localized urticarial reaction may be seen with the infusion of meperidine and the patient should not be labeled as having a hypersensitivity to the drug in the absence of sys¬ temic signs or symptoms.
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