Anaphylaxis due to formaldehyde released from root-canal disinfectant

doi:10.1034/j.1600-0536.2002.470405.x

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Wiley InterScience

Contact Dermatitis

Volume 47 Issue 4, Pages 215 - 218

Published Online: 20 Dec 2002

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Anaphylaxis due to formaldehyde released from root-canal disinfectant

Makoto Kunisada ¹ , Atsuko Adachi ¹ , Hiroshi Asano ² and Tatsuya Horikawa ³

¹ Department of Dermatology, Hyogo Prefectural Kakogawa Hospital, 770–1, Awazu, Kakogowa-cho, Kakogawa, 675–8555, Japan, ² Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho Chuo-ku Kobe, 650–0017, Japan, ³ Department of Dermatology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho Chuo-ku Kobe, 650–0017, Japan

Correspondence to Atsuko Adachi
Department of Dermatology
Hyogo Prefectural Kakogawa Hospital
770–1, Awazu, Kakogowa-cho
Kakogawa, 675–8555
Japan
Tel: +81 794230001
Fax: +81 794233820
e-mail: faadachi@dd.iij4u.or.jp

KEYWORDS

anaphylaxis • delayed-type hypersensitivity • formaldehyde • immediate-type hypersensitivity • paraformaldehyde • root-canal disinfectants • specific IgE • dental patients. © Blackwell Munksgaard • 2002

ABSTRACT

A 50-year-old woman developed anaphylaxis 8 h after application of a paraformaldehyde-containing root canal disinfectant. Radioallergosorbent test showed that she had a high level of formaldehyde-specific IgE in her serum. Prick tests to formaldehyde and paraformaldehyde showed immediate-type responses to both. We reviewed the literature describing cases with anaphylaxis/angioedma caused by formaldehyde in root canal disinfectants and found that about 1/2 of the reported cases developed symptoms over 2 h after dental treatment. We speculated that the delay in the manifestation of her symptoms was possibly due to gradual formaldehyde release from paraformaldehyde and time lag of penetrating and diffusing of formaldehyde outside the dentin. Patch testing showed that she also had delayed-type allergy to formaldehyde, paraformaldehyde and eugenol. Physicians should pay attention to root canal disinfectants, even if anaphylaxis occurs several hours after dental treatment.

Accepted for publication 22 August 2002

DIGITAL OBJECT IDENTIFIER (DOI)

10.1034/j.1600-0536.2002.470405.x About DOI