PMID- 16672013
OWN - NLM
STAT- MEDLINE
DCOM- 20070806
LR  - 20171116
IS  - 0905-6157 (Print)
IS  - 0905-6157 (Linking)
VI  - 17
IP  - 3
DP  - 2006 May
TI  - Acute allergic reaction to an iron compound in a milk-allergic patient.
PG  - 230-3
AB  - A child allergic to cow's milk developed a mild systemic allergic reaction after 
      the first dose of Ferplex 40 (iron proteinsuccinylate). Skin tests and in vitro 
      studies were performed in the child, in three cow's milk-allergic controls and in 
      a non-allergic control. Milk, casein and iron proteinsuccinylate (Ferplex 40) 
      were used for skin tests, specific immunoglobulin E (IgE) determination, sodium 
      dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), immunoblotting and 
      enzyme allergo sorbent test (EAST) inhibition. A review of the drug information 
      sheet and contact with the manufacturer were also performed. Although 
      proteinsuccinylate is indeed a succinylated casein (each dose containing about 
      575 mg of casein) there was no indication of the milk protein content in the 
      prescribing information provided by the manufacturer. Skin tests and specific IgE 
      were positive in the case and in all allergic controls, except for EAST to iron 
      proteinsuccinylate in one control. In EAST, iron proteinsuccinylate in solid 
      phase was 100% inhibited by casein and casein in solid phase was inhibited 74% by 
      iron proteinsuccinylate. SDS-PAGE of iron proteinsuccinylate showed a broad 46 
      kDa band and a blur of aggregated material. On immunoblot, the patient's IgE 
      reacted to this heavily aggregated material and in the native casein extract 
      recognized a 35-kDa band. The allergenicity of succinylated casein 
      (proteinsuccinylate) among milk-allergic children is demonstrated. The protein 
      source used in drug-protein conjugates should always be indicated by the 
      manufacturer (as it should be in foods) to avoid potential risks to allergic 
      patients.
FAU - Larramendi, Carlos H
AU  - Larramendi CH
AD  - Unidad de Alergia, Hospital Marina Baixa, Villajoyosa, Alicante, Spain. 
      chernandol@seaic.es
FAU - Marco, Francisco M
AU  - Marco FM
FAU - Garcia-Abujeta, Jose L
AU  - Garcia-Abujeta JL
FAU - Mateo, Maxima
AU  - Mateo M
FAU - de la Vega, Ana
AU  - de la Vega A
FAU - Sempere, Jose M
AU  - Sempere JM
LA  - eng
PT  - Journal Article
PL  - England
TA  - Pediatr Allergy Immunol
JT  - Pediatric allergy and immunology : official publication of the European Society 
      of Pediatric Allergy and Immunology
JID - 9106718
RN  - 0 (Caseins)
RN  - 0 (Metalloproteins)
RN  - 0 (Succinates)
RN  - VBJ9L90P4L (iron protein succinylate)
SB  - IM
MH  - Anemia/drug therapy
MH  - Caseins/analysis
MH  - Child, Preschool
MH  - Drug Hypersensitivity/*etiology
MH  - Drug Labeling
MH  - Humans
MH  - Immunosorbent Techniques
MH  - Metalloproteins/*adverse effects/chemistry
MH  - *Milk Hypersensitivity
MH  - Skin Tests
MH  - Succinates/*adverse effects/chemistry
EDAT- 2006/05/05 09:00
MHDA- 2007/08/07 09:00
CRDT- 2006/05/05 09:00
PHST- 2006/05/05 09:00 [pubmed]
PHST- 2007/08/07 09:00 [medline]
PHST- 2006/05/05 09:00 [entrez]
AID - PAI373 [pii]
AID - 10.1111/j.1399-3038.2005.00373.x [doi]
PST - ppublish
SO  - Pediatr Allergy Immunol. 2006 May;17(3):230-3. doi: 
      10.1111/j.1399-3038.2005.00373.x.