Thomas E. Van Metre, MD, Gary L. Rosenberg, MD, Surender K

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Presentation transcript:

Pain and dermal reaction caused by injected glycerin in immunotherapy solutions Thomas E. Van Metre, MD, Gary L. Rosenberg, MD, Surender K. Vaswani, MD, Sharon R. Ziegler, N.Franklin Adkinson, MD Journal of Allergy and Clinical Immunology Volume 97, Issue 5, Pages 1033-1039 (May 1996) DOI: 10.1016/S0091-6749(96)70254-3 Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 1 Pain scores produced by injected glycerin concentrations and volumes in 15 subjects in 12 dose groups. Arrows indicate medians. Probability (p) values shown were derived by Mann-Whitney U Test.7, 8 A two-factor (volume, percent glycerin) analysis of variance9 was also used to confirm that both volume and percent glycerin were related to pain score (p < 0.005) and that volume × percent glycerin interaction was also highly significant (p < 0.001). GL, Glycerin; NS, not significant. Journal of Allergy and Clinical Immunology 1996 97, 1033-1039DOI: (10.1016/S0091-6749(96)70254-3) Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 2 Correlation between pain scores and the responsible injected total dose (volume × concentration) of glycerin. Arrows indicate medians. Journal of Allergy and Clinical Immunology 1996 97, 1033-1039DOI: (10.1016/S0091-6749(96)70254-3) Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 3 Clinically important pain frequency (number of patients in each dose group with grade 4 [intolerable] and grade 3 [annoying] pain): correlation with the responsible injected total dose (volume × concentration) of glycerin. GL, Glycerin. Journal of Allergy and Clinical Immunology 1996 97, 1033-1039DOI: (10.1016/S0091-6749(96)70254-3) Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 4 Expansion and decline of a typical subcutaneous area of induration, “glycerin button,” at the site of an injection of glycerin (Subject d, 0.5 ml of 20% glycerin, left upper arm low). Journal of Allergy and Clinical Immunology 1996 97, 1033-1039DOI: (10.1016/S0091-6749(96)70254-3) Copyright © 1996 Mosby, Inc. Terms and Conditions

FIG. 5 Comparison of pain scores produced by the usual dose of immunotherapy solution with those produced by the same dose of glycerin solution and the nearest volume of HSA diluent in the eight subjects in the immunotherapy recipient group. NS, Not significant. Journal of Allergy and Clinical Immunology 1996 97, 1033-1039DOI: (10.1016/S0091-6749(96)70254-3) Copyright © 1996 Mosby, Inc. Terms and Conditions