{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:26:30Z","timestamp":1777418790529,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[1996,1,1]],"date-time":"1996-01-01T00:00:00Z","timestamp":820454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[1996,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To report a patient with an anaphylactic reaction related to povidone administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARY:<\/jats:title>\n                    <jats:p>A 37-year-old man with a history of allergic rhinitis presented with urticaria, dyspnea, wheezing, rhinorrhea, and dysphonia 20 minutes after the intraarticular administration of mepivacaine hydrochloride and paramethasone acetate in his right knee. Two months after this episode, he was admitted for controlled provocation tests. Tests on mepivacaine were negative. The preparation of paramethasone contained the excipients benzalkonium chloride, polysorbate 80, and povidone. In vitro tests and provocation were negative with polysorbate 80 and benzalkonium chloride, but positive with povidone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Povidone, a mixture of synthetic polymers, is commonly used as an excipient in pharmaceutical products, an additive in food products, and a dispersant and stabilizer in hairsprays. Although it is well tolerated when used topically or parenterally, local and systemic effects have been reported. Furthermore, multiorgan involvement resulting from accumulation of the drug in the reticuloendothelial system has been described. The immunologic properties of povidone have not been explored in humans, but have been in animals. In fact, the capacity of povidone to release histamine and its immunogenicity are proportional to its molecular weight. An immunoglobulin (Ig) E-mediated hypersensitivity reaction in asthma has been reported. In our case, povidone was responsible for the syndrome. However, we cannot determine the exact mechanism. An unspecific histamine release and\/or an IgE-mediated hypersensitivity could be involved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Povidone was responsible for a severe anaphylactic reaction in our patient. The possibility of an iatrogenic adverse effect caused by the excipient but not by the active ingredient should be considered in patients exhibiting similar symptoms. We believe that the excipients used in the preparation of all medicines should be disclosed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/106002809603000107","type":"journal-article","created":{"date-parts":[[2017,1,13]],"date-time":"2017-01-13T14:18:51Z","timestamp":1484317131000},"page":"37-40","source":"Crossref","is-referenced-by-count":25,"title":["Anaphylactic Shock following Povidone"],"prefix":"10.1177","volume":"30","author":[{"given":"Ma Angeles Gonzalo","family":"Garijo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 A Dur\u00e1n","family":"Quintana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro Bobadilla","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar M\u00e1iquez","family":"Asuero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1996,1,1]]},"reference":[{"key":"bibr-bibr1-106002809603000107","unstructured":"American Pharmaceutical Association Production Staff and The Pharmaceutical Society of Great Britain Production Staff. Handbook of pharmaceutical excipients. Washington, DC: Pharmaceutical Press, 1986: 234\u20139."},{"key":"bibr-bibr2-106002809603000107","unstructured":"Reynolds JEF. Martindale: the extra pharmacopoeia. 29th ed. London: The Pharmaceutical Press, 1989: 1437."},{"key":"bibr-bibr3-106002809603000107","doi-asserted-by":"publisher","DOI":"10.1002\/j.1552-4604.1990.tb03432.x"},{"key":"bibr-bibr4-106002809603000107","first-page":"26","volume":"696","year":"1983","journal-title":"World Health Organ Tech Rep Ser"},{"key":"bibr-bibr5-106002809603000107","unstructured":"Sax NI. Dangerous properties of industrial materials. 5th ed. New York: Van Nostrand Reinhold, 1979: 923."},{"key":"bibr-bibr6-106002809603000107","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1980.01640300092029"},{"key":"bibr-bibr7-106002809603000107","unstructured":"Weiner M. Adverse reactions to drug formulations: a handbook of excipients. New York: Marcel Dekker, 1989: 168\u20139."},{"key":"bibr-bibr8-106002809603000107","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(86)90477-0"},{"key":"bibr-bibr9-106002809603000107","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(84)90114-3"},{"key":"bibr-bibr10-106002809603000107","first-page":"293","volume-title":"Manual de alergia e inmunolog\u00eda, diagn\u00f3stico y tratamiento","author":"Mellon MH","year":"1990"},{"key":"bibr-bibr11-106002809603000107","unstructured":"Resoluci\u00f3n AP (91)I del Consejo de Europa sobre la Declaraci\u00f3n de excipientes presentes en las especialidades farmac\u00e9uticas Estraburgo, Francia de 11 de Abril de 1991."},{"key":"bibr-bibr12-106002809603000107","first-page":"555","volume":"34","author":"Dehlschlaegel G","year":"1983","journal-title":"Hautarzt"},{"key":"bibr-bibr13-106002809603000107","first-page":"170","volume":"14","author":"Z\u00f6ller J","year":"1990","journal-title":"Dtsch Z Mund Kieler Gesichtschir"},{"key":"bibr-bibr14-106002809603000107","first-page":"538","volume":"74","author":"Dupont A","year":"1967","journal-title":"Bull Soc Fr Dermatol Syphil"},{"key":"bibr-bibr15-106002809603000107","first-page":"569","volume":"39","author":"Fartasch M","year":"1988","journal-title":"Hautarzt"},{"key":"bibr-bibr16-106002809603000107","first-page":"419","volume":"14","author":"Cabanne F","year":"1969","journal-title":"Ann Anat Pathol"},{"key":"bibr-bibr17-106002809603000107","first-page":"397","volume":"84","author":"Reske-Nielsen E","year":"1976","journal-title":"Acta Pathol Microbiol Scand A"},{"key":"bibr-bibr18-106002809603000107","first-page":"1418","volume":"51","author":"Lagrue G","year":"1970","journal-title":"Vie Medicale"},{"key":"bibr-bibr19-106002809603000107","doi-asserted-by":"publisher","DOI":"10.1080\/22953337.1983.11718940"},{"key":"bibr-bibr20-106002809603000107","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196204122661503"},{"key":"bibr-bibr21-106002809603000107","first-page":"325","volume":"41","author":"Ameille J","year":"1985","journal-title":"Rev Pneumol Clin"},{"key":"bibr-bibr22-106002809603000107","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1985.tb02506.x"},{"key":"bibr-bibr23-106002809603000107","unstructured":"Dukes MNG, Aronson JK. 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