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Comparison of reactivity to a metallic disc and 2% aluminium salt in 366 children, and reproducibility over time for 241 young adults with childhood vaccine-related aluminium contact allergy

Journal article
Authors Anette Gente-Lidholm
Annica Inerot
Martin Gillstedt
Elisabet Bergfors
Birger Trollfors
Published in Contact Dermatitis
Volume 79
Issue 1
Pages 26-30
ISSN 0105-1873
Publication year 2018
Published at Institute of Clinical Sciences, Department of Dermatology and Venereology
Institute of Medicine, School of Public Health and Community Medicine
Pages 26-30
Language en
Keywords aluminium, contact allergy, follow-up studies, immune tolerance, itchy nodules, patch test, prognosis, persistent subcutaneous nodules, adsorbed-vaccines, hypersensitivity, adjuvants, extracts, Allergy, Dermatology
Subject categories Pediatrics, Allergology, Dermatology and Venereal Diseases


Background: An aluminium hydroxide-adsorbed pertussis toxoid vaccine was studied in 76 000 children in the 1990s in Gothenburg, Sweden. Long-lasting itchy subcutaneous nodules at the vaccination site were seen in 745 participants. Of 495 children with itchy nodules who were patch tested for aluminium allergy, 377 were positive. In 2007-2008, 241 of the positive children were retested. Only in one third were earlier positive results reproduced. Objectives: To further describe patch test reactions to different aluminium compounds in children with vaccine-induced aluminium allergy. Patients/Methods: Positive patch test results for metallic aluminium (empty Finn Chamber) and aluminium chloride hexahydrate 2% petrolatum (pet.) were analysed in 366 children with vaccine-induced persistent itching nodules tested in 1998-2002. Of those, 241 were tested a second time (2007-2008), and the patch test results of the two aluminium preparations were analysed. Results: Patch testing with aluminium chloride hexahydrate 2% pet. is a more sensitive way to diagnose aluminium contact allergy than patch testing with metallic aluminium. A general decrease in the strength of reactions to both aluminium preparations in 241 children tested twice was observed. Conclusions: Aluminium contact allergy can be diagnosed by patch testing without using metallic aluminium.

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