Anaphylaxis to Total Parenteral Nutrition Components Diagnosed by Skin Tests

Parenteral nutrition (PN) is a critical intervention for patients unable to tolerate enteral nutrition. Commercially available multi-chamber PN formulations are widely used due to their safety and cost-effectiveness. However, hypersensitivity reactions (HSRs), including anaphylaxis, must be carefully considered. Here, we report on a 38-year-old female with intestinal obstruction due to peritoneal dissemination of colon cancer who developed anaphylaxis to a multi-chamber PN formulation. Skin prick and intradermal tests identified the specific chamber as the causative component. PN-related HSRs are rare, but can severely impact nutritional management. Identifying specific allergens is crucial for avoiding unnecessary PN discontinuation. This case highlights the importance of incorporating allergy testing into the management of multi-chamber PN, allowing safe continuation of nutrition and guiding individualized strategies for patients at risk of hypersensitivity.

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Publication Details

Journal
The Journal of Dermatology
Published
2025-12-27
DOI
https://doi.org/10.1111/1346-8138.70127
Primary Topic
Clinical Nutrition and Gastroenterology
Type
article
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article

Anaphylaxis to Total Parenteral Nutrition Components Diagnosed by Skin Tests

Toshihiko Komai, Toshiaki Shimizu, Keishi Fujio, Takayuki Yotsuyanagi et al.
The Journal of Dermatology
Clinical Nutrition and Gastroenterology
article

Anaphylaxis to Total Parenteral Nutrition Components Diagnosed by Skin Tests

Toshihiko Komai, Toshiaki Shimizu, Keishi Fujio, Takayuki Yotsuyanagi, Ken Kurokawa, Fujishiro Mitsuhiro, Tadashi Hayakawa, Keita Murakami, Nobumi Suzuki
article en

Abstract

Parenteral nutrition (PN) is a critical intervention for patients unable to tolerate enteral nutrition. Commercially available multi-chamber PN formulations are widely used due to their safety and cost-effectiveness. However, hypersensitivity reactions (HSRs), including anaphylaxis, must be carefully considered. Here, we report on a 38-year-old female with intestinal obstruction due to peritoneal dissemination of colon cancer who developed anaphylaxis to a multi-chamber PN formulation. Skin prick and intradermal tests identified the specific chamber as the causative component. PN-related HSRs are rare, but can severely impact nutritional management. Identifying specific allergens is crucial for avoiding unnecessary PN discontinuation. This case highlights the importance of incorporating allergy testing into the management of multi-chamber PN, allowing safe continuation of nutrition and guiding individualized strategies for patients at risk of hypersensitivity.

The Journal of DermatologyVol. 53(3)
The University of Tokyo (JP)
Zero hunger
Openalex Percentile: Top 35%
Clinical Nutrition and Gastroenterology
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Anaphylaxis to Total Parenteral Nutrition Components Diagnosed by Skin Tests — Toshihiko Komai, Toshiaki Shimizu, et al. · The Journal of Dermatology (2025) | TGRS Research Map | TGRS