2005 Bepotastine-Induced Urticaria, Cross-Reactive with Other Antihistamines

Thursday, 15 October 2015
Hall D1 Foyer (Floor 3) (Coex Convention Center)

Jasmina Golez, MD , Pulmonology and Allergy, Ambulanta Meznar, Celje, Slovenia

Jaechun Lee, MD, PhD , Internal Medicine, Jeju National University School of Medicine, Jeju, South Korea

Eunkyoung Lee, MBA , Regional Pharmacovigilance Center, Jeju National University Hospital, Jeju, South Korea

Second-generation antihistamines are widely prescribed for the control of symptoms of allergic inflammation such as itchy hives, coryza, and itchy eyes. In rare circumstances, these drugs can provoke allergic inflammation. Hypersensitivity to bepotastine besilate, a second-generation antihistamine has never been reported.

A 17-year-old schoolgirl, whose paroxysmal itchy hives had been controlled with bepotastine, experienced aggravation of the hives. An oral provocation test confirmed her hypersensitivity to bepotastine and cross-reactivity to levocetirizine. She showed no reaction to chlorpheniramine, ketotifen, or olopatadine among the 13 antihistamines tested.

While searching for an antihistamine to control her itchy hives, we found that she also exhibited cross-reactivity to various antihistamines with different chemical structures from that of bepotastine, which is not predicted according to the chemical classification of antihistamines.

We report on a case of hypersensitivity to bepotastine besilate in a patient with chronic spontaneous urticaria.