CASE REPORT article
Front. Allergy
Sec. Allergens
Volume 6 - 2025 | doi: 10.3389/falgy.2025.1663395
This article is part of the Research TopicAllergen cross-reactivity - a challenge in daily practiceView all articles
Case Report: Severe IgE-mediated Hypersensitivity to Carboxymethylcellulose with Tolerance to Crosscarmellose and Microcrystalline Cellulose
Provisionally accepted
Rhea Schreiber1,2
Carole Guillet1,2*- 1Medical Faculty, Universitat Zurich, Zürich, Switzerland
- 2Allergy Unit, Department of Dermatology, University Hospital Zürich, Zurich, Switzerland
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We present a rare case of severe IgE-mediated hypersensitivity to carboxymethylcellulose (CMC) following an intraarticular knee injection with triamcinolone acetonide (Triamcort®). The patient experienced a grade IV anaphylactic reaction shortly after administration. Diagnostic workup, including skin prick testing and basophil activation test, confirmed sensitization to CMC. Importantly, the patient tolerated medications containing crosscarmellose and microcrystalline cellulose without adverse reactions, suggesting no clinically relevant cross-reactivity. This case highlights the need to consider excipients such as CMC as potential triggers of severe allergic reactions especially in cases of unexplained anaphylaxis to injectable medication and underscores the importance of thorough allergological assessment to ensure safe future treatments.
Keywords: Carboxymethylcellulose, Excipient allergy, Intra-articular injection, Cellulose derivatives, Anaphylactic allergic reaction
Received: 10 Jul 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Schreiber and Guillet. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Carole Guillet, carole.guillet@usz.ch
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