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0/M, Two Cases of Urticaria Developed by Hemo-Q and Albumax Solution / urticaria
Chief complaint
or Title
Two Cases of Urticaria Developed by Hemo-Q and Albumax Solution / urticaria
Difficulty For student/For resident
Eun Soo Kim, MD,  Byoung Chul Kwon, MD, Sung Yon Choi, MD, Kyu-Earn Kim, MD, Myung Hyun Sohn, MD[mhsohn@yumc.yonsei.ac.kr],
2005.03.22
Department of Pediatrics and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
* History
<< CASE 1 >>
Patient`s age/sex; 13 months/male
Present illness; A 13-month-old male was referred for evaluation of urticaria after the third dose of hepatitis B vaccination. He developed urticaria after Hemo-Q solution ingestion for iron deficiency anemia.
Past Hitory; He was born by C-sec at IUP 40wk and birth weight was 4.2kg. He had been previously diagnosed as having atopic dermatitis and he was breast-fed for 1 year. He developed urticaria when he was introduced to solid food, but hydrolyzed formulae didn't cause skin manifestations.
Family history: There was a history of allergy in the father(atopic dermatitis/rhinitis) and brother(atopic dermatitis/egg allergy). His mother gave a history of craving for milk during her pregnancy and she continued to eat milk during lactation frequently.

<< CASE 2 >>
Patient`s age/sex; 9 months/male
Present illness; A 9-month-old male presented for evaluation of atopic dermatitis. He developed urticaria after Hemo-Q solution ingestion for iron deficiency anemia.
Past Hitory; He was born by C-sec at IUP 38wk and birth weight was 3kg. He was breast-fed for 4 months and he developed urticaria when he was introduced to cow's milk formula, but hydrolyzed formulae didn't cause skin manifestations.
Family history: Family history revealed allergies in the mother(rhinoconjunctivitis) and brother(rhinitis). His mother gave a history of craving for milk and egg during her pregnancy and she continued to eat milk and egg during lactation frequently.


* R.O.S.& P/Ex
<< CASE 1 >>
His initial weight of body was 10.5kg(50-75p) and he was 80cm in height(75-90p). Skin was warm and dry, and there was no abnormal skin rash. Breath sound was clear without rale or wheezing, and there was no cardiac murmur. Abdomen, back and extremities were normal.

<< CASE 2 >>
Family history revealed allergies in the mother(rhinoconjunctivitis) and brother(rhinitis). His mother gave a history of craving for milk and egg during her pregnancy and she continued to eat milk and egg during lactation frequently.
* Lab
<< CASE 1 >>
CBC: WBC 7,790/mm3, Hb 11 g/dL ( MCV 71.8 fL, MCH 23.8 pg, MCHC 33.1 g/dL)
Total Eosinophil Count 250/mm3, Total IgE 38.39 KIU/L, IgG 510 mg/dL, IgA 28.5 mg/dL, IgM 70.6 mg/dL
MAST: Milk 3+, Cheese 3+, Egg white 4+, Wheat 4+

<< CASE 2 >>
CBC:  WBC 10,080/mm3, Hb 10.8 g/dL (MCV 74.8 fL, MCH 26.8 pg, MCHC 35.8 g/dL), TEC 320/mm3, Total IgE 239.9 KIU/L
MAST: Milk 4+, Cheese 4+, Egg white 4+, Wheat 4+, Soy bean 2+, Pork 2+
* Clinical Course
<< CASE 1 >>
Open challenge test
When Hemo-Q or Albumax solution were taken or rubbed on back, erythematous papules and wheals were developed in 10-20minutes, but other antianemics which don't contain milk or egg protein contents(Hemocontin, Hemonia and Feritop solution) didn't show skin manifestations.
Clinical course
He is 18 months old now, and his weight of body is 12kg(50-75p) and he is 85cm in height(75-90p). He developed urticaria after the intake of milk and milk-containing foods(yogurt, cheese), and his mother has not attempted to give him egg after then.

<< CASE 1 >>
Open challenge test
Erythematous papules and wheals were shown on the face and neck after Hemo-Q solution ingestion within minutes, but when Hemo-Q solution was rubbed on arm, he didn't develop urticaria. Feritop solution ingestion didn't cause skin manifestations.
Clinical course
He is 15 months old now, and his weight of body is 10kg(25p) and he is 78cm in height(25-50p). He developed urticaria to milk, peas, wheat, orange, strawberry, carrot and kiwi, and his mother didn't attempt to give him egg.


* If you click the image you able to see original image








Table 1. Kinds of Antianemics Marketed in Korea

IngredientBrand name(Manufacturer or Distributor)
Iron proteinsuccinylate
(casein complex)
Hemo-Q solution(Dae Woong)
Iron acetyl-transferrin hydroglyceride
(ovalbumin complex)
Albumax solution(Han Lim)
Bolgre solution(Chong Kun Dang Pharm)
Sodium ferric gluconate complexBolgran solution(Chong Kun Dang Pharm)
Feritop solution(Il Dong)
Hemosalang solution(Kyung Dong)
Fenough solution(Bo Ryung)
Santamon solution(Korean Drug)
Redbol solution(Cho Dang)
Ladyline solution(Sam Jin)
Bloodn-S solution(Dae Rim)
Ferritin complex solution(Je il)
Ferric hydroxide-polymaltose complexAlburon solution(Han Lim)
Bihema syrup(Cho-A)
Breed solution(Dae Rim)
Hemohome solution(Shin Poong)
Hemocom solution(Il Yang)
Ferrummate solution(Choong Wae)
Ferrumkid solution(Choong Wae)
Feroba ace solution(Bu Kqang)
Fematon solution(Cho-A)
Polysaccharide-iron complexHemonia-F syrup(Dong Koo)
Hemogenic-forte syrup(Dae Hwa)
Hemotop syrup(H-Pharm)
Sodium feredetateFeroma solution(Kwang dong)
[Case list]   
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