Antihistamines are commonly used for the treatment of urticaria. Some antihistamines contain dyes and preservatives which have themselves been shown to produce or exacerbate urticaria. Tartrazine is used predominantly as an additive in food and drugs. To stimulate awareness of this problem, the author reports a case of recurrent urticaria induced by tartrazine in an antihistamine in a 25-year-old male patient. His skin lesions recurred after treatment with oral antihistamine containing tartrazine. The provocation tests with 0.1mg of tartrazine and the antihistamine containing tartrazine induced urticaria within two hours. The provocation tests with aspirin and sodium benzoate were negative.
Adult ; Aspirin ; Coloring Agents ; Histamine Antagonists ; Humans ; Male ; Skin ; Sodium Benzoate ; Tartrazine* ; Urticaria*

Objective and METHOD: In order to identify the aggravating agents for intrinsic asthma, we performed ASA- and food additive-challenge tests on 182 subjects diagnosed as having intrinsic asthma. The following tests were performed: Lysine-aspirin bronchoprovocation test to confirm aspirin-sensitivity, sodium bi-sulfite (40-200mg) oral provocation test for sulfite sensitivity, tartrazine oral provocation test (50mg) for tartrazine sensitivity, and sodium benzoate (400mg) oral provocation test for sodium benzoate sensitivity. Positive reaction was defined as decrease in FEV, by more than 20% from the baseline value after the provocation. RESULT: Seventy-five (41.2%) of 182 subjects showed positive responses to more than one agent among the aspirin and three food additives challenged. The prevalence of aspirin-sensitivity was the highest (22.5%), followed by sulfite-sensitivity (8.8%), and then concurrent sensitivity to both aspirin and sulfite (6.0% ), to both aspirin and tartrazine (1.6% ), to aspirin, sulfite and tartrazine (1.1%) and to aspirin, sulfite and sodium benzoate (0.5%). Rhino-sinusitis was noted in 62.5% of aspirin-sensitive asthmatic subjects, 60% of sulfite-sensitive ones, and 80% of tartrazine-sensitive ones. Urticaria was noted in 21.4% of aspirin-sensitive asthmatic subjects, 16.6% of sulfite-sensitive ones and 6.3% of tartrazine-sensitive ones. Thirty-seven to 83% of positive responders had no adverse reaction history. CONCLUSION: These findings suggest that ASA and food additive challenge tests should be considered as a screening test to evaluate any aggravating factors in subjects with intrinsic asthma, even though they may not have experienced any adverse reactions.
Aspirin* ; Asthma* ; Food Additives* ; Mass Screening ; Prevalence ; Sodium ; Sodium Benzoate ; Tartrazine ; Urticaria

Because the red and bright color of corolla is the main indicator for the quality assessment of good safflower,the dyed safflower is sometimes found at the herbal market,what is influence on this herb quality and efficacy. A total of 127 safflower samples was therefore collected from different cultivating areas and herbal markets in China to develop a rapid method to identify the dyed safflower. Near-infrared spectroscopy(NIRS) combined with characteristic identification,high performance liquid chromatography(HPLC),principal component analysis(PCA) and partial least squares regression analysis(PLS) were employed to differentiate safflower from dyed safflower samples,and further quantify the levels of the 6 dyes,i.e. tartrazine,carmine,sunset yellow,azorubine,acid red 73 and orange Ⅱ in the dyed safflower. The results indicated that the 50 safflower samples and 77 dyed safflower samples were located at different regions in PCA cluster diagram by NIR spectra. Tartrazine,carmineand and sunset yellow were found in the 77 dyed safflower samples with the amounts of 0. 60-3. 66,0. 11-1. 37,0. 10-0. 71 mg·g-1,respectively. It indicated that the three dyes were the common and main dyes in the dyed safflower. However,azorubine,acid red 73 and orange Ⅱ were not detected in all herb samples. A total of 62 dyed safflower samples were chosen as calibration samples to develop the model for estimating the amount of dyes in dyed safflower. The estimating accuracy was verified by another 15 dyed safflower samples. The values of tartrazine,carmine and sunset yellow in dyed safflower samples were compared between the NIRS and HPLC methods. Each value of mean absolute difference(MAD) was less than 5%. The correlation coefficients of tartrazine,carmineand and sunset yellow were 0. 970,0. 975,0. 971,respectively. It indicated the data quantified by NIRS and HPLC were consistence. It is concluded that NIRS can not only differentiate safflower from dyed safflower,but also quantify the amount of the dyes. NIRS is suitable for rapidly identify the quality of safflower.
Azo Compounds ; Benzenesulfonates ; Carmine ; Carthamus tinctorius ; chemistry ; China ; Coloring Agents ; analysis ; Naphthalenesulfonates ; Spectroscopy, Near-Infrared ; Tartrazine

Aspirin(ASA) and NSAIDs can induce bronchoconstriction in 10~20% of adult asthmatics patients. Inhalation of lysine-ASA(L-ASA) has been described as an alternative method for diagnosis of ASA-sensitive asthma. To further understand the characterlstics of ASA-sensitive asthmas. we studied 38 asthmatic patients with ASA -sensitivity (36 intrinsic and 2 extrinsic asthma) proven by L-ASA bronchoprovocation test (BPT). Most were female (male to female ratio was 27:73). Twenty (53%) of them had no previous history of adverse reactions when exposed to ASA. Twenty nine (79%) had rhino-sinusitis symptoms. Early asthmatic response was observed in 16 (42%) patients, late only response in 16(42%), and dual response in 6(16%) patients. The threshold of L-ASA to provoke a positive response ranged from 11.2 to 180 mg/ml and most (68.3%) had a positive response after the inhalation of 180 mg/ml. Concurrent sensitivity to sulfite was noted in 14 (36%) patients, followed by sensitivity to tartrazine in one (3%) patient. None showed a positive response to sodium benzoate. After the avoidance from ASA/ NSAIDs with administration of anti-asthmatic medications, symptom and medication scores reduced in 26(87%) patients among 30 followed patients. They were classified into the improved group: four (13%) patients belonged to the not-improved group. There were no significant differences in clinical characteristics between the improved and not- improved group (p>0.05). In conclusion, L-ASA BPT could be considered as a useful method to diagnose ASA -sensitive asthma and be used to screen the causative agent for asthmatic patients with intrinsic type, especially in female patients with rhino-sinusitis and/or nasal polyp, even though they do not have arty history of adverse reactions. Cessation of exposure and proper treatment may allow to reduce symptom and medication scores.
Adult ; Anti-Inflammatory Agents, Non-Steroidal ; Asthma* ; Bronchoconstriction ; Diagnosis ; Female ; Humans ; Inhalation ; Nasal Polyps ; Sodium Benzoate ; Tartrazine

PURPOSE: To review the role of food additives in asthma and provide a practical approach for evaluation, diagnosis, and management of additive-induced asthma. METHODS: Information was gathered from original articles, selected reviews and abstracts published in peer-reviewed journals and from selected textbook chapters, supplemented by the clinical experience of the authors. RESULTS: In some patients, food additive ingestion can induce bronchospasm or exacerbation of symptoms in patients with chronic asthma. The most implicated agents are sulfites, followed by tartrazine, monosodium glutamate and others. However, geographic variations exist depending on the dietary habits. CONCLUSION: Food additives are worth considering as possible causes of bronchospasm or worsening of asthma. The medical history may be suggestive, particularly when symptoms occur to commercially prepared foods or to multiple unrelated foods. Physicians should also think of food additives in patients whose asthma is poorly controlled in spite of appropriate routine allergy evaluation, environmental control, and optimal pharmacologic therapy. Except for a few natural additives, allergy skin test and in-vitro tests are unreliable. A titrated oral challenge testing, preferably in a blind fashion would be the definitive diagnostic procedure.
Asthma* ; Bronchial Spasm ; Coloring Agents ; Diagnosis ; Eating ; Food Additives* ; Food Habits ; Humans ; Hypersensitivity ; Skin Tests ; Sodium Glutamate ; Sulfites ; Tartrazine

Non-acetylated salicylates have been recommended for use as alternatives to nonsteroidal anti-inflammatory drugs (NSAIDs) in aspirin and/or tartrazine-sensitive patients. We experienced a case of an aspirin-sensitive asthmatic patient who developed a broncho-obstructive reaction after taking 100 mg of sodium salicylate. The result of this study suggests that sodium salicylate may cross-react with aspirin in aspirin-and tartrazine-sensitive patients.
Aspirin/*adverse effects/immunology ; Asthma/*complications/diagnosis/etiology ; Bronchial Provocation Tests ; Cross Reactions ; Drug Hypersensitivity/*complications/diagnosis/etiology ; Female ; Humans ; Middle Aged ; Sodium Salicylate/*adverse effects/immunology ; Tartrazine/adverse effects

Many different additives include preservatives, stabilizers, conditioners, thickeners, colorings, flavorings, sweeteners, and antioxidants. Despite the multitude of additives known, only a small number has been associated with hypersensitivity reactions. A number of investigators have suggested that a significant population of patients with allergic diseases has symptoms related to the ingestion of food additives. However, the incidence and mechanism of reactions to additives in patients with chronic urticaria, angioedema, and atopic dermatitis remain unknown. A few studies of monosodium glutamate is reported to be associated with atopic dermatitis, but their relationship remains unknown. The best known dye is tartrazine. The group of azo dyes includes ponceau and sunset yellow. Amaranth (FD&C red no. 5) was banned from use in the US in 1975 because of claims related to carcinogenicity. Most of them are reported to be associated with aggravation of atopic dermatitis. Parabens are aliphatic esters of parahydroxybenzoic acid. Sodium benzoate is a closely related substance usually reported to cross-react with these compounds. These agents, which are widely used as preservatives in both food and drugs, are well recognized as causes of severe contact dermatitis. Additives would have to act as haptens to create a response mediated by IgE. The majority of these reactions are not of the immediate hypersensitivity type. Many cases of additive-provoked urticaria or dermatitis occur as late as 24 hours after challenge, arguing against an IgE-mediated mechanism. In conclusion, the exact relationship between food additives and the allergic diseases still remains to be solved.
Angioedema ; Antioxidants ; Azo Compounds ; Coloring Agents ; Dermatitis ; Dermatitis, Atopic ; Dermatitis, Contact ; Eating ; Esters ; Food Additives ; Food Hypersensitivity ; Haptens ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Immunoglobulin E ; Incidence ; Parabens ; Research Personnel ; Sodium Benzoate ; Sodium Glutamate ; Sweetening Agents ; Tartrazine ; Urticaria