ALKOHOL-ANAPHYLAXIE: ALLERGIE GEGENUBER DEM ATHANOL-METABOLITEN ESSIGSAURE?

The diagnosis of anaphylactoid reactions to alcoholic beverages may be troublesome, as not only ethanol but also other ingredients, such as molds, yeasts, preservatives, and colouring or flavouring agents have to be considered. True sensitization to ethanol itself is a rare event. In man ethanol is metabolized to acetic acid via acetaldehyde. - In a 22-year-old female, who had suffered repeatedly from anaphylactic reactions after the ingestion of alcohol beverages and of vinegar containing dishes, strongly positive prick test reactions to acetic acid (9.6% and 0.96%) and vinegar were observed; control tests in other subjects with these agents were negative. Skin tests with ethanol, acetaldehyde, wine and beer yielded only negative or irritative reactions. Oral provocation with increasing amounts (0.01-0.1-1.0 ml) of ethanol (absulute, analytical grade) in tap water resulted in severe anaphylaxis after ingestion of 1.0 ml. Thus in this patient pure ethanol elicits anaphylactic reactions that seem to be caused by an immediate type allergic reaction to the ethanol metabolite acetic acid.