Local anesthetics are frequently used in dental practice. An allergic reactions to these drugs, however, are very rare and it has been reported that they have a high safety factor. We encountered a suspicion of 2 different amide types of local anesthetics allergy. A 4 year 5 month old male patient was referred to our hospital. He had atopic dermatitis and bronchial asthma. His dental history showed thatt he first ime was afterh e was treatedu nder locala nesthetic(Ora® Ct), fivheo urs afteri njection, when he had edema of the eyes. The second time, he had a prurigo of the chest, with a different type of locala nesthetic(Citanest-Octapresin® Ct) injection Whene 15 minutes afterH. e was examined with a prick test for these anesthetic drugs a negative reaction was found. The intaradermal skin test, however, showed a positive reaction when he was still near the pediatric hospital.
We suspected for two different amide type of anesthetic allergies. Firstly, We examined the drug using the lymphocyte stimulation test(DLST)with Xylocaine®Ct and Xylocaine®for phleboclysis, these showed a negative reaction,
Secondly, we examined using an intaradermal skin test which showed a negative reaction with Xylocaine®for phleboclysis.
It does not affect the concentration of serum Ig E, histamine, and the number of eosinophilic leukocytes. These inspects, however, at a higher level compared with the healthy controls.
Thirdly, we examined using the challenge test under general anesthesia. No allergic response was shown with a dose of 1 ml Xylocaine® for phleboclysis.
There was no increase in the concentration of the serum Ig E, histamine, and the number of eosinophilic leukocytes.
In this case, we have some doubts concerning the external allergic response to the preservative agent in the anesthetic solution.