Urticaria associated with parenteral nutrition. 2005

James S Scolapio, and Marcus Ferrone, and Robert A Gillham
Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA. scolapio.james@mayo.edu

We report a 53-year-old female patient with short bowel syndrome who developed urticaria after administration of cyclic parenteral nutrition (PN). The urticaria occurred 2 hours into the 12-hour nocturnal infusion and resolved completely 1 hour after discontinuation of the PN infusion. The urticaria occurred despite removing lipids from the 3-in-1 PN solution. The urticaria did not occur when the multivitamin preparation was removed from the PN. Upon rechallenge with a PN solution containing a multivitamin, the urticaria reoccurred. Prick skin testing using the multivitamin in increasing aliquots was negative. Serum tryptase and 12-hour urinary histamine level during PN infusion containing the multivitamin was unchanged compared with baseline measurements. The patient had no allergic reaction using a similar dose of an oral multivitamin. This case illustrates that allergic reactions from PN infusion may occur and that the multivitamin preparation can be the cause.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010288 Parenteral Nutrition The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D005260 Female Females
D005512 Food Hypersensitivity Gastrointestinal disturbances, skin eruptions, or shock due to allergic reactions to allergens in food. Allergy, Food,Food Allergy,Hypersensitivity, Food,Allergies, Food,Food Allergies,Food Hypersensitivities,Hypersensitivities, Food
D005526 Food, Formulated Food and dietary formulations including elemental (chemically defined formula) diets, synthetic and semisynthetic diets, space diets, weight-reduction formulas, tube-feeding diets, complete liquid diets, and supplemental liquid and solid diets. Diet, Chemically Defined,Diet, Elemental,Diet, Formula,Diet, Synthetic,Dietary Formulations,Chemically Defined Diet,Synthetic Diet,Chemically Defined Diets,Dietary Formulation,Diets, Chemically Defined,Diets, Elemental,Diets, Formula,Diets, Synthetic,Elemental Diet,Elemental Diets,Foods, Formulated,Formulated Food,Formulated Foods,Formulation, Dietary,Formulations, Dietary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012778 Short Bowel Syndrome A malabsorption syndrome resulting from extensive operative resection of the SMALL INTESTINE, the absorptive region of the GASTROINTESTINAL TRACT. Bowel Syndrome, Short,Bowel Syndromes, Short,Short Bowel Syndromes,Syndrome, Short Bowel,Syndromes, Short Bowel
D014581 Urticaria A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. Hives,Urticarial Wheals,Urticarial Wheal,Urticarias,Wheal, Urticarial,Wheals, Urticarial
D014815 Vitamins Organic substances that are required in small amounts for maintenance and growth, but which cannot be manufactured by the human body. Vitamin

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