Is anaphylaxis with egg a risk factor for propofol sensitivity?

Abstract

BACKGROUND: Propofol rarely causes allergic reactions. On the other hand, its relationship with egg allergy is con-troversial. This study aimed to evaluate propofol sensitivity in patients with suspected allergic reactions to propofol and patients with proven immunoglobulin E-mediated egg allergy.METHODS: Patients who underwent propofol skin tests due to suspected hypersensitivity reaction to propofol (group 1) or children with confirmed immunoglobulin E mediated or mixed egg allergy (group 2) were included in the study as two groups. The data were obtained from the patients' medical records and retrospectively analyzed. Propofol sensitivity was confirmed by determining the positivity of skin tests. Egg allergy has been confirmed by in-vivo and in-vitro tests, including oral challenge tests.RESULTS: Thirty-two of the patients had a history of suspected hypersensitivity reactions after using propofol. The remaining 16 had a confirmed egg allergy. Propofol sensitivity was confirmed in 3 patients, one with a suspected hyper-sensitivity reaction to propofol and two with egg allergy. Both of the egg-allergic patients had histories of anaphylaxis after consuming small amounts of egg, and they had never been exposed to propofol.CONCLUSIONS: Propofol skin test may be positive in patients with severe immunoglobulin E-mediated hen's egg allergy. To avoid reactions that may occur during the use of propofol, detailed history of hen's egg allergy should be obtained, and in the presence of severe reactions, an alternative drug should be preferred. (Cite this article as: Siileyman A, Guler N. Is anaphylaxis with egg a risk factor for propofol sensitivity? Gazz Med Ital -Arch Sci Med 2022;181:545-51. DOI: 10.23736/S0393-3660.21.04673-8)