A 19 year old man had panhypopituitarism and diabetes insipidus secondary to an ectopic pinealoma. After 10 mth of pitressin tannate in oil (PTO) therapy he suffered 2 episodes of anaphylaxis. He was skin test positive to PTO and aqueous pitressin (PIT) but not to lysine 8 vasopressin (LVP). Intranasal LVP maintained water balance without allergic reaction. The patient's isolated serum free leukocytes released histamine when challenged with as little as 10μU of PIT. His serum decreased the histamine release response to PIT indicating the presence of blocking (IgG) antibodies. His serum was also able passively to sensitize normal leukocytes to PIT indicating the presence of reaginic (IgE) antibodies. LVP did not induce histamine release nor did it act as a hapten, since it failed to inhibit histamine release by PIT even at a thousandfold excess. Arginine 8 vasopressin was not available for leukocyte histamine release studies but as it is the homologous hormone and cross reacts extensively with LVP, it is unlikely to be the inciting antigen. The authors consider that the patient in this case was hypersensitive to a bovine or porcine contaminant of PTO. The in vitro technique described may be useful to study similar instances of hypersensitivity.
|Original language||English (US)|
|Number of pages||6|
|Journal||Johns Hopkins Medical Journal|
|State||Published - Dec 1 1972|
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