An urticarial IgE-mediated reaction to interferon β-1b
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An authoritative review of interferon (IFN) β toxicity in the treatment of MS stated that type I or IV allergic reactions have not been observed or reported.1 Our recent experience provides the opportunity to reexamine this important point. We report a woman with MS who manifested a type I, IgE-mediated, allergic response to the protein IFN β-1b.
Case report.
A 32-year-old woman had three discrete episodes of nonstereotyped neurologic deficit over 9 years. Her brain and spinal MRI results were consistent with demyelinating disease. Although she declined lumbar puncture, we considered relapsing-remitting MS to be an appropriate diagnosis given her clinical history and imaging data. Shortly after beginning IFN β-1b, the injections evoked multiple side effects: flulike symptoms requiring nonsteroidal anti-inflammatory drugs, urinary urgency with incomplete bladder evacuation lasting 4 hours after each injection, leg cramps, and exacerbation of preexisting asthma. She had previously required albuterol therapy and short courses of antibiotics for asthmatic exacerbations that typically lasted …
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