BACKGROUND Polyethylene glycols (PEGs) are widely used as excipients in drugs, cosmetics and household products. Immediate-type allergy to PEGs including anaphylaxis are rare. The recent introduction of the mRNA based COVID-19 vaccines has led to an increased focus on PEG as a possible culprit of allergic reactions to the vaccine. A low awareness of the allergenic potential of PEG among consumers, manufacturers and doctors leads to under-diagnosis and under-reporting of allergy to PEGs, putting patients at risk of repeated severe reactions. OBJECTIVES To investigate clinical manifestations, time to diagnosis and impact of a PEG allergy diagnosis on the daily life of patients diagnosed with allergy to PEG from 2010 to 2019. METHOD Ten patients diagnosed with allergy to PEG were included. Detailed clinical history was obtained, and allergy investigations had been performed at the time of diagnosis. All patients were contacted and asked to retrospectively complete a questionnaire about causes and impact on daily life of an allergy to PEG, scored on a likert scale (0-10) before and after diagnosis. RESULTS Eight patients had experienced at least one anaphylactic reaction requiring adrenaline treatment. Anaphylaxis was primarily caused by antibiotic/analgesic tablets, depot-steroids, antacids and laxatives. Seven patients reported repeated reactions before diagnosis (median 3, range 2-6). Median time from first reaction to diagnosis was 20 months (range 2-120). None of the patients experienced severe allergic reactions after the diagnosis. Median likert score of the impact on daily life before diagnosis was 7 compared to 4 after diagnosis. CONCLUSION AND CLINICAL RELEVANCE The clinical manifestations of PEG allergy are often dramatic. Improved awareness about the clinical presentation and common culprits, clear product labelling and a standardized nomenclature is needed to ensure timely diagnosis of PEG allergy to prevent repeated anaphylactic reactions with severe impact on patient's lives.

中文翻译：

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聚乙二醇（PEG）过敏10例患者的临床表现及对日常生活的影响

背景技术聚乙二醇(PEG)广泛用作药物、化妆品和家用产品中的赋形剂。对 PEG 的立即型过敏包括过敏反应是罕见的。最近推出的基于 mRNA 的 COVID-19 疫苗导致人们越来越关注 PEG 作为疫苗过敏反应的可能罪魁祸首。消费者、制造商和医生对 PEG 的潜在过敏性认识不足，导致对 PEG 过敏的诊断和报告不足，使患者面临重复发生严重反应的风险。目的 调查 2010 年至 2019 年诊断为 PEG 过敏的患者的临床表现、诊断时间和 PEG 过敏诊断对日常生活的影响。方法 纳入 10 名诊断为 PEG 过敏的患者。获得了详细的临床病史，并且在诊断时已经进行了过敏调查。联系所有患者并要求他们回顾性完成一份关于 PEG 过敏的原因和对日常生活影响的问卷，在诊断前后按李克特量表 (0-10) 评分。结果 8 名患者经历了至少一种需要肾上腺素治疗的过敏反应。过敏反应主要由抗生素/镇痛药片、长效类固醇、抗酸剂和泻药引起。7 名患者在诊断前报告了重复反应（中位数 3，范围 2-6）。从第一反应到诊断的中位时间为 20 个月（范围 2-120）。所有患者在诊断后均未出现严重的过敏反应。诊断前对日常生活影响的中位数李克特评分为 7，而诊断后为 4。结论和临床相关性 PEG 过敏的临床表现通常是戏剧性的。需要提高对临床表现和常见罪魁祸首的认识、清晰的产品标签和标准化的命名，以确保及时诊断 PEG 过敏，以防止重复出现严重影响患者生活的过敏反应。