چکیده (انگلیسی):

Background: There are problems in diagnosis of allergy to amide-type local anesthetic agents (ALAs), because
definitive diagnosis is not obtained by in vivo tests, which are used for the diagnosis. Consequently, patients
may be exposed to risk. There are few diagnoses based on in vitro tests, and there are almost no relevant
studies.
Methods: Authors examined involvement of allergic reaction using the leukocyte migration test (LMT) through
multiple standpoints in 43 patients who underwent suspected diagnosis of allergy to ALAs.
Results: Rate of LMT-positives was 54%, and especially the positive rate of lidocaine hydrochloride preparations
was significantly high. In 15 positives to lidocaine hydrochloride preparations, all cases were indicated as
positive in a test with drugs containing antiseptic agent, but only 3 cases were indicated as positive in a test
with lidocaine hydrochloride alone. In addition, test with paraben was conducted in 4 cases; 2 cases were confirmed
as positive. In relevance of histories of drug or food allergies, development rates of ALAs-allergies were
the highest in both allergies, and were 35% and 13%, respectively.
Conclusions: There is a high possibility that these adverse reactions were caused by pseudoallergy to drug.
Even by allergic reactions, it was assumed that 80% of them might be caused by antiseptic agents such as
paraben. In addition, it was suggested that ALAs, especially lidocaine hydrochloride preparations have high antigenicity
(sensitizing property). Furthermore, it was considered that patients with past history of drug or food allergies
have a high potential for manifestation of the reactions.