Q:

9/6/2012
We have a patient that would like to have an intralipid (Liposyn 11) infusion during an IVF cycle. The product contains 5% soybean oil. The patient has a history of soy allergy (no positive RAST) with tongue tingling and scratchy throat from soy milk. She tolerates soy sauce and a vitamin that contains soy. My question is do you know of any guidelines for possible skin testing to this product (the manufacturer does not) or premedicating the patient prior to the infusion?

A:

Thank you for your inquiry.

There is no “guideline” for skin testing to this product, but there are two reports in the literature (1, 2) where skin testing to Intralipid has been described. In Reference Number 1 only prick tests were done to the “neat” preparation. However, in Reference Number 2, both epicutaneous and intracutaneous tests were done. Both of these references are available to you online at no charge. I have copied for you below the link to each reference.

In Reference Number 2, skin prick testing was done to a concentration of 100 mg/mL of Intralipid, and intradermal tests were done using concentrations of 1, 10, and 100 mg/mL.

In both of the studies reported, tests were negative.

Thank you again for your inquiry and we hope this response is helpful to you.

References:
1. Buchman AL and Ament ME. Comparative hypersensitivity in intravenous lipid emulsions. Journal of Parenteral and Enteral Nutrition 1991; 15(3):345-346.
2. Bacaicoa MTL, et al. Cutaneous response to Diprivan (propofol) and Intralipid in patients with leguminous and egg allergy. Rev Esp Allergol Immunol Clin 1998 (June); 13(3):153-157.


Links:
http://pen.sagepub.com/content/15/3/345.full.pdf+html

http://revista.seaic.es/junio98/153-157.pdf

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology