Hypersensitivity to Vitamins | EurêkAlert!

Vitamins are heterogeneous but essential biochemicals that the human body needs for its well-being. However, the human body cannot produce vitamins, which must be assimilated through food. Alternatively, their deficiency can induce serious illnesses like rickets, pellagra or scurvy which can be disabling or even fatal. For this reason, each vitamin has been identified and obtained chemically for pharmaceutical and industrial purposes allowing their use as medicine or food enrichment. However, like any other drug, in addition to toxic reactions, that is to say hypervitaminosis, vitamins can induce hypersensitivity reactions, such as contact dermatitis or anaphylaxis, in particular in their synthetic form and according to their usage. Given their importance for the body, the avoidance strategy is not possible with vitamins, which had to be taken by the patient, despite his awareness. It is therefore important to understand what approach should be used when a patient has hypersensitivity to a vitamin.- Previously, in 1982, only Bundgaard and De Weck had included an entire chapter on hypersensitivity to vitamins in their book “Allergic Reactions drugs ”(Springer-Verlag-New York) and attempted to investigate this matter. In the meantime, 39 years later, new case reports and studies have appeared in the literature, giving new insights and suggestions on the management of vitamin hypersensitivity. Thus, the effort of this book has been to collect most of the case reports from mainly English literature, through an Internet search of Pubmed and Google Scholar, and to attempt to organically and systematically illustrate the mechanisms vitamin awareness training, as understood. or postulated by clinicians and researchers who have treated a patient “in the field” sensitive to vitamins, with an emphasis on clinical aspects, the diagnostic approach and therapeutic management, trying to highlight much more a minor subject of drug hypersensitivity. A specific chapter is devoted to each vitamin and, after a brief introduction regarding the biological activity, its use, a sketch of its metabolism and potential chemical derivatives are illustrated, but the most interesting part is represented by the experiences of the different authors. and related. discussions of their case reports or studies with a precise description of previous management strategies, showing, for example, desensitization protocols used by different authors, concentrations for diagnostic skin tests or recommended challenge tests, thus illustrating options available to clinicians. The author has limited himself to making some considerations on the basis of vitamin metabolism, the complete data in the literature and his clinical experience with drug allergy. Anyway, he also considers that, vitamins in their synthetic form are not always the real culprits of an allergic reaction. Sometimes even the excipients in pharmaceutical formulations of vitamins can induce hypersensitivity, while this problem certainly does not occur with natural vitamins in foods. Of course, being the immunoallergologist author, his approach is influenced by his clinical and cultural background. Fortunately, vitamin hypersensitivity is not as common as antibiotic allergy, but it’s probably also underestimated, misdiagnosed, and certainly described anecdotally. For this reason, the author has tried to describe in a svelte and pragmatic manner to summarize actual clinical knowledge and experiences, in the hope that the book may also be of use to allergists, pediatricians, dermatologists, nutritionists, clinical pharmacologists and pharmacists. , thus any clinician can find practical indications for managing a patient with hypersensitivity to vitamins.

About the publisher

Gianfranco Calogiuri was born in Lecce (Italy) on March 5, 1961. He graduated in Medicine in November 1988 at the Chieti University “Gabriele D’Annunzio” (Italy) and in November 1992 and obtained the Council Certificate in as Specialist in Allergy and Clinical Immunology at the University of Bari “Aldo Moro” from the Department of Allergy and Clinical Immunology headed by Prof. Alfredo Tursi. In 1994 he obtained a master’s degree in allergy and pediatric immunology at the pediatrics department of the University of Bari, then he was assigned as a medical assistant in different hospitals of the Azienda Sanitaria Lecce at the first aid center of first, then, in internal medicine, infectious diseases, dermatology, hematology, clinical pathology and neurology. In 2005 he was hired at the pneumology hospital of San Cesario di Lecce and in 2011 he worked as an allergy and pneumology consultant at the asthma center of the “Ninetto Melli” hospital in San Pietro Vernotico (Brindisi- Italy) until 2016 In 2012 he obtained his PhD in Immunology and Infectious Diseases at the University of Bari with a thesis on the immunological status of tracheostomy patients.

From 2016 to 2020, he worked in the pneumology and allergy department of the Gallipoli “Sacro Cuore” hospital (40 km from Lecce). For the need of well-trained doctors due to the COVID 19 pandemic, he was temporarily assigned in early 2020 to the pulmonology department of the Vito Fazzi civilian hospital in Lecce. He has been a member of the European Academy of Allergy and Clinical Immunology (EAACI) since 2003 and member of ENDA (European Network for Drug Allergies). He has published more than 70 articles in Italian and international medical journals as an author and co-author and a contribution to books. He also collaborates with the Department of Allergy and Clinical Immunology at the University of Bari to study the pathways of drug allergy, whether mediated by IgE or T cells, diagnosis, management , prevention and therapy. In 2003 he married his beloved wife Maria Rita and they have a son, Pier Francesco.

Keywords: Heterogeneous bioactive substances, Allergy, Cosmetics, Fat-soluble vitamins, Food excipients, Food fortification, Vitamin deficiency, Hypersensitivity, Dexpanthenol, Immediate-type reaction, Pantothenate, Pantothenic acid, Urticaria, Retinoids, Retinol, DRESS syndrome.

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