Disodium cromoglycate or cromolyn, available since 1973 is an antiasthmatic/ antiallergic drug acting as a mast cell stabilizer.
Incidence
About 20 cases reported in the literature.
One death (bronchospasm).
Clinical manifestations
Anaphylactic shock: 3 cases published.
Bronchospasm: one death reported.
Rhinitis, conjunctivitis, urticaria.
Differentiate from dermatitis, myositis, gastroenteritis (2% of patients) and cough, dry mouth, pharyngeal irritation, mild transient bronchospasm (attributed to local irritant effects of the powder on hyperreactive airways).
Diagnostic methods
Cutaneous testing.
Skin prick-tests (10 mg/ ml): positive in a few patients.
Intradermal skin tests (10 mg/ ml): positive with syndromic reaction in one case.
Specific IgE (RAST) by spontaneous binding of DSCG to human serum albumin (one case).
Conjunctival challenge test (20 mg/ ml).
Bronchial challenge (20 mg/capsule).
Mechanisms
IgE-mediated hypersensitivity (positive skin tests, passive transfer, specific IgE).
DSCG is a weak hapten (only hydrogen bonds can be found between drug and host cells or tissue).
Management
Avoidance.
Allergic sensitization may disappear with the time.