Progestogen Hypersensitivity.

Sergio E Chiarella, Kathleen M Buchheit, Dinah Foer

The journal of allergy and clinical immunology. In practice 2023 Dec

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Progestogen hypersensitivity (PH) is a heterogeneous disease characterized by diverse cutaneous manifestations, bronchospasm, and/or anaphylaxis. Possible triggers include ovarian progesterone and exogenous progestogens. The timing of symptoms is critical to diagnose PH: during the luteal phase of the menstrual cycle for the endogenous form and after exposure to progestins for exogenous PH. Diagnostic modalities such as progesterone skin testing have low sensitivity and specificity for PH. When exogenous PH is suspected, the allergist should consider a progestogen challenge. Treatment strategies should be tailored for each patient, including symptom-directed therapies, ovulation suppression, and progesterone desensitization. Future studies should explore the mechanisms of PH, validation of diagnostic criteria, and standardization of treatment strategies. Copyright © 2023 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Citation

Sergio E Chiarella, Kathleen M Buchheit, Dinah Foer. Progestogen Hypersensitivity. The journal of allergy and clinical immunology. In practice. 2023 Dec;11(12):3606-3613.e2