Abstract

CARVALHO, Sara; OLIVEIRA, Guilherme; DUARTE, Fátima Cabral  and  BARBOSA, Manuel Pereira. Case Report: Late hypersensitivity to inhaled budesonide. Rev Port Imunoalergologia [online]. 2020, vol.28, n.1, pp.51-55. ISSN 0871-9721.  https://doi.org/10.32932/rpia.2020.03.031.

Background: Budesonide is a glucocorticoid used in the treatment of various pathologies such as asthma and rhinitis. Hypersensitivity reactions to budesonide are uncommon and are mostly late reactions. Clinical case: Female patient, 59 years old, started inhaled therapy with budesonide 160mcg + formoterol 4.5mcg in a context of recurrent cough and wheezing with 6 months of evolution. A week after the onset of this treatment, the patient presented with bronchospasm, oropharyngeal burning of progressive aggravation followed by edema of the uvula. Later, she was referred for immunoallergology consultation. From the allergology study, epicutaneous tests with the standard Portuguese Group of Contact Dermatitis were positive for budesonide (0.1%) and tests with patient’s products were positive for budesonide 160mcg + formoterol 4.5mcg, both at 96h. Discussion/Conclusion: The diagnosis of delayed hypersensitivity reaction to inhaled budesonide was established and epicutaneous tests confirmed type IV hypersensitivity.

Keywords : Allergic rhinitis; bronchial asthma; budesonide; hypersensitivity type IV; patch tests.

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