Anaphylaxis to Polyvinylpyrrolidone in Povidone-Iodine for Impetigo Contagiosum in a Boy with Atopic Dermatitis

Abstract

Background: Povidone-iodine (PVP-I) is widely used in antiseptic agents. Immediate allergic reaction to PVP-I preparations is very rare and often overlooked, as it is difficult to diagnose. Polyvinylpyrrolidone (PVP) is thought to play a role in the underlying mechanism. We examined the usefulness of the histamine release test (HRT) for definite diagnosis of PVP allergy. Method: A 9-year-old boy with eosinophilia (1,500/µl) and elevated total IgE (1,376 IU/ml) was suspected clinically of having a PVP allergy, as he had anaphylaxis twice when he was administered a PVP-I solution for impetigo contagiosum. Skin prick tests (SPTs) were performed with a PVP-I solution, PVP (K30), gentamicin sulfate and 2 other medicines containing PVP. HRT was assessed using peripheral blood basophils. Results: SPTs to PVP-I solution, PVP-K30 and other medicines were all negative. Histamine release was observed on stimulation by PVP in the presence of autologous serum, although it was not observed in the absence of autologous serum. Conclusions: This observation was in line with the clinical findings that anaphylaxis had not developed despite the long use of PVP-I solution, but developed only when he received PVP-I solution treatment where basophils could contact PVP-I in the presence of serum, which was probably due to a broken skin and vessel condition. Furthermore, our results suggest the usefulness of HRT in the diagnosis of PVP allergy, and the possibility that negative SPT does not entirely rule out PVP allergy.

A simplified superovulation protocol using split-single administration of Folltropin®-V in hyaluronan: application to purebred sheep

“…Although these agents were effective at eliciting a slow release of FSH to induce a superovulatory response, in humans, PG and polyvinylpyrrolidone have caused allergic reactions (Catanzaro and Smith 1991;Gonzalo et al 1999;Yoshida et al 2007;Marques et al 2011), while aluminum hydroxide induced neuropathological reactions and macrophagic myofascitis (Gherardi et al 2001;Shaw and Petrik 2009). In contrast, there have been no reports of side effects from HA administered in mammals.…”

Foreign Body Emboli following Cerebrovascular Interventions: Clinical, Radiographic, and Histopathologic Features

“…Allergic reactions to PVP have been reported. [16][17][18] Aside from its use in catheter technology, PVP has many applications-for example, as a thickening and emulsifying agent in toothpastes, shampoos, contact lens solutions, and gel and tablet formulations. In combination with iodine, it forms the polyvinylpyrrolidone-iodine solution better known as Betadine (Betadine Microbicides, Stamford, Connecticut).…”

“…Two instances of anaphylaxis to Betadine were traced to its PVP, rather than iodine, component. 17,18 An anaphylactic reaction to an acetaminophen tablet was traced to its PVP ingredient. 16 However, our cases would be more consistent with a type IV, cell-mediated response, rather than a type I, an anaphylactic one.…”

Hidden exogenous proteins in wine: problems, methods of detection and related legislation - a review

“…On the other hand, PVPP removes also quercitin (Laborde et al 2006) and resveratrol (Threlfall et al 1999), representing components that bring health benefit associated with moderate wine consumption (Castellari et al 1998). Furthermore, PVPP is contemporaneously reported as Generally Recognized as Safe (GRAS) approved for many uses by FDA, even if there have been documented cases of allergic reactions to polyvinylpyrrolidone (Ronnau et al 2000;Adachi et al 2003;Yoshida et al 2008).…”