Prednisone Side Effects And Warnings

Learn Facts and Information About Prednisone, Both Side Effects and Benefits

Allergic Reactions to Prednisone

Prednisone - Allergic Reactions and Symptoms

Corticosteroids are well-known for reducing inflammation. Whether you need to treat seasonal allergies which cause sneezing and runny nose or year-round allergies, Prednisone reduces inflammation linked to these allergic reactions. One of the many downsides of this drug treatment is that it lowers the immune system, often causing immune diseases[1]. Serious side effects you might experience during corticosteroid therapy are severe allergic reactions like skin rash or face swelling, and complications of these allergic reactions include anaphylaxis and angioedema.

Anaphylaxis is a serious, even life-threatening allergic reaction which often occurs within seconds of exposure to an allergen. Allergens are substances perceived as threats by the body, which produce an excessive immune response often including skin rash, nausea, and a weak pulse. Skin reactions are almost always present in anaphylaxis and come along with redness or very pale skin, itching and hives. Hives is the common term used for urticaria, a skin condition in which the skin becomes pale red with itchy bumps, causing a burning sensation. Other anaphylaxis symptoms are trouble breathing, swollen tongue and throat, cough and stridor[2]. Stridor is a breath sound which appears when a turbulent air flow passes through the larynx. It indicates a severe airway obstruction, so, in this case, patients often receive tracheal intubation.

These respiratory signs along with cardiovascular signs such as cardiac arrest and fast heart rate are the most common symptoms of anaphylactic shock. It is a life-threatening condition in which patients need cardiopulmonary resuscitation as soon as possible, in order to avoid heart or pulmonary failure. Other than observing these common symptoms of anaphylaxis, doctors confirm the diagnosis by allergy tests with blood samples. They often ask the patient to make a detailed list of the medicine he took recently.

Angioedema is a skin reaction similar to urticaria in which the skin and the mucous membranes swell. In spite of the fact that all body areas can be affected, in many cases swelling only affects the eyes and the lips. Angioedema affects the area beneath the dermis, while urticaria affects both the dermis and epidermis. Urticaria makes the skin appear red with spots on the surface, while angioedema is accompanied by red swellings below the surface of the skin. Both skin reactions usually last about 24 hours. Angioedema can be treated with subcutaneous adrenaline injection or oral antihistamines which are medications that reduce the symptoms of allergic reactions. Angioedema may affect all organs, especially the peripheral areas such as skin, urinary tract, and genitals[3]. When it affects the larynx, angioedema becomes a life-threatening condition because of the throat tightness and breathing trouble[4]. This condition is not itchy like urticaria and it has a specific look. Lesions appear as small or large patches colored in red, with a pale halo along the margins and a fiery red center[5]. Acute allergic angioedema caused by corticosteroids such as Prednisone occurs within 1-2 hours of exposure to the allergen, while the non-allergic type can occur after days or months of treatment.

References:

  1. Jones & Bartlett Learning, Nurse's Drug Handbook Tenth Edition, 2011
  2. Sampson H., Munoz-Furlong A., Campbell R., The Journal of Allergy and Clinical Immunology, 2006
  3. Sabroe R., Black A., Angiotensin-converting enzyme inhibitors and angioedema, 1997
  4. Pigman E., Scott J., Angioedema in the emergency department: the impact of angiotensin-converting enzyme inhibitors, 1993
  5. Greaves M, J allergy Clin Immunol. Ed., Chronic urticaria, 2000