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Kortikosteroidler ile İlişkili Alerjik Reaksiyonlar

Year 2017, , 4 - 11, 01.01.2017

Pınar Gökmirza Özdemir Mehtap Yazıcıoğlu

https://doi.org/10.5222/j.child.2017.004

Abstract

Kortikosteroidler antiinflamatuar etkilerinden dolayı tüm dünyada oldukça yaygın olarak kullanılmaktadırlar. Metabolik yan etkileri ile farmakolojik özelliklerine bağlı reaksiyonlar iyi bilinmektedir. Bu özelliklerinden bağımsız olarak aşırı duyarlılık reaksiyonlarına da neden olabilirler. Ancak alerjik hastalıkların tedavisinde sıklıkla kullanılmaları; kortikosteroidlere bağlı aşırı duyarlılık reaksiyonlarının yanlışlıkla altta yatan alerjik hastalığa bağlı olduğu şeklinde yorumlanmasına ve çoğu zaman gözden kaçmasına neden olmaktadır. Kortikosteroidlerle oluşan tüm alerjik reaksiyonların sıklığı %0,1-0,3 arasında tahmin edilmektedir. Bu makalede kortikosteroidlerin molekül yapıları ve buna bağlı olarak yapılan sınıflama, kortikosteroidlerle immünolojik mekanizmalarla oluşan alerjik reaksiyonların klinik bulguları, tanı ve tedavisi ile ilgili konular ele alınmıştır.

Keywords

Kortikosteroid allerji kontakt dermatit

References

  • Baeck m, Nicolas JF, Pilette c, Tennstedt d, Goossens A. Allergic hypersensitivity to topical and systemic cor- ticosteroids: a review. Allergy 2009;64:978-94.
  • https://doi.org/10.1111/j.1398-9995.2009.02038.x
  • Baeck m, Goossens A. Immediate and delayed allergic hypersensitivity to corticosteroids: practical guidelines. Contact Dermatitis 2012;66(1):38-45.
  • Baker A, empson m, The R, Fitzharris P. Skin tes- ting for immediate hypersensitivity to corticosteroids: a case series and literature review. Clin Exp Allergy 2015;45:669-76.
  • https://doi.org/10.1111/cea.12441
  • otani ım, Banerji A. Immediate and delayed hyper- sensitivity reactions to corticosteroids: Evaluation and management. Curr Allergy Asthma Rep 2016;16(3):18.
  • https://doi.org/10.1007/s11882-016-0596-7
  • compalati e, Guerra l, Rogkakou A, zanella c, Scordamaglia A, Passalacqua G. Angioedema after administration of methylprednisolone to treat drug allergy. Allergy 2007;62:1346-8.
  • currie G, Paterson e, Keenan F, Nath S, Watt S. An unexpected response to intravenous hydrocortisone succinate in an asthmatic patient. Br J Clin Pharmacol 2005;60:342.
  • caimmi S, caimmi d, Bousquet PJ, demoly P. Succinate as opposed to glucocorticoid itself allergy. Allergy 2008;63:1641-3.
  • Gelincik A, Yazici H, emre T, Yakar F, Buyukozturk S. An alternative approach to a renal transplant patient who experienced an immediate type systemic reaction due to methylprednisolone sodiumsuccinate. J Investig Allergol Clin Immunol 2009;19:162-3.
  • Koutsostathis N, Vovolis V. Severe immunoglobulin E-mediated anaphylaxis to intravenous methylpredni- solone succinate in a patient who tolerated oral methy- lprednisolone. J Investig Allergol Clin Immunol 2009;19:330-2.
  • Walker Aı, Räwer H-c, Sieber W, Przybilla B. Immediate-type hypersensitivity to succinylated corti- costeroids. Int Arch Allergy Immunol 2010;155:86-92.
  • https://doi.org/10.1159/000318678
  • Kamm Gl, Hagmeyer Ko. Allergic- type reactions to corticosteroids. Ann Pharmacother 1999;33:451-60.
  • https://doi.org/10.1345/aph.18276
  • Nowak-Wegrzyn A, Shapiro G, Beyer K, Bardina l, Sampson H. Contamination of dry powder inhalers for asthma with milk proteins containing lactose. J Allergy Clin Immunol 2004;113:558-60.
  • https://doi.org/10.1016/j.jaci.2003.11.015
  • eda A, Sugai K, Shioya H, Fujitsuka A, ıto S, ıwata T, et al. Acute allergic reaction due to milk proteins contaminating lactose added to corticosteroid for injec- tion. Allergol Int 2009;58:137-9.
  • https://doi.org/10.2332/allergolint.C-07-59
  • Savvatianos S, Giavi S, Stefanaki e, Siragakis G, manousakis e, Papadopoulos NG. Cow’s milk allergy as a cause of anaphylaxis to systemic corticosteroids. Allergy 2011;66:983-5.
  • https://doi.org/10.1111/j.1398-9995.2011.02566.x
  • levyY, Segal N, Nahum A, marcus N, Garty B-z. Hypersensitivity to methylprednisolone sodium succi- nate in children with milk allergy. J Allergy Clin Immunol In Pract 2014;2:471-4.
  • https://doi.org/10.1016/j.jaip.2014.03.002
  • Venturini m, lobera T, del Pozo md, González ı, Blasco A. Immediate hypersensitivity to corticostero- ids. J Investig Allergol Clin Immunol 2006;16:51-6.
  • muroi N, Nishibori m, Fujii T, Yamagatam, Hosoi S, Nakaya N, et al. Anaphylaxis from the carboxy- methylcellulose component of barium sulfate suspensi- on. N Engl J Med 1997;337:1275-7.
  • https://doi.org/10.1056/NEJM199710303371804
  • Bigliardi Pl, ızakovic J,Weber Jm, Bircher A. Anaphylaxis to the carbohydrate carboxymethylcellu- lose in parenteral corticosteroid preparations. Dermatology 2003;207:100-3.
  • https://doi.org/10.1159/000070958
  • Field S, Falvey e, Barry J, Bourke J. Type 1 hyper- sensitivity reaction to carboxymethylcellulose follo- wing intra articular triamcinolone injection. Contact Dermatitis 2009;61:302-3.
  • https://doi.org/10.1111/j.1600-0536.2009.01636.x
  • dewachter P, mouton-Faivre c. Anaphylaxis to mac- rogol 4000 after a parenteral corticoid injection. Allergy 2005;60:705-6.
  • https://doi.org/10.1111/j.1398-9995.2005.00783.x
  • Sohy c, Vandenplas o, Sibille Y. Usefulness of oral macrogol challenge in anaphylaxis after intra articular injection of corticosteroid preparation. Allergy 2008;63:478-9.
  • https://doi.org/10.1111/j.1398-9995.2007.01610.x
  • Borderé A, Stockman A, Boone B, Franki A, coppens m, lapeere H, et al. A case of anaphylaxis caused by macrogol 3350 after injection of a corticos- teroid. Contact Dermatitis 2012;67:376-8.
  • https://doi.org/10.1111/j.1600-0536.2012.02104.x
  • Patel A, Bahna S. Immediate hypersensitivity reacti- ons to corticosteroids. Ann Allergy Asthma Immunol 2015;115:178-82.
  • https://doi.org/10.1016/j.anai.2015.06.022
  • Ventura mT, calogiuri GF, muratore l et al. Cross- reactivity in cell-mediated and IgE-mediated hypersen- sitivity to corticosteroids. Curr Pharm Des 2006:12: 3383-91.
  • https://doi.org/10.2174/138161206778194006
  • Pryse-Phillips We, chandra RK, Rose B. Anaphylactoid reaction to methylprednisolone pulsed therapy for multiple sclerosis. Neurology 1984;34:1119- 21.
  • https://doi.org/10.1212/WNL.34.8.1119
  • Rodrigues-Alves R, Spínola-Santos A, Pedro e, Branco-Ferreira m, Pereira-Barbosa m. Immediate hypersensitivity to corticosteroids: finding an alternati- ve. J Investig Allergol Clin Immunol 2007;17:284-5.
  • matura G. Contact allergy to corticosteroids. Allergy 2000;55:698-704.
  • https://doi.org/10.1034/j.1398-9995.2000.00121.x
  • Skoet R, zachariae R, Agner T. Contact dermatitis and quality of life: a structured review of the literature. Br J Dermatol. 2003;149:452–6.
  • https://doi.org/10.1046/j.1365-2133.2003.05601.x
  • Baeck m, chemelle J A, Rasse c,Terreux R, Goossens A. C16-methylated corticosteroids are less far allergenic than the non-methylated molecules. Contact Dermatitis 2011;64:305-12.
  • https://doi.org/10.1111/j.1600-0536.2011.01874.x
  • Baeck m, Goossens A. Patients with airborne sensiti- zation/contact dermatitis from budesonide-containing aerosols ‘by proxy’. Contact Dermatitis 2009:1:1-8.
  • https://doi.org/10.1111/j.1600-0536.2009.01575.x
  • malik m, Tobin A m, Shanahan F,o’morain c, Kirby B, Bourke J. Steroid allergy in patients with inflammatory bowel disease. Br J Dermatol 2007;157:967-9.
  • miranda Romero A, Sánchez Sambucety P, Bajo c, martinez m, Garcia munoz m. Genital oedema from contact allergy to prednicarbate. Contact Dermatitis 1998;38:228.
  • https://doi.org/10.1111/j.1600-0536.1998.tb05725.x
  • Valsecchi R, Reseghetti A, leghissa P, cologni l, cortinovis R. Erythema-multiforme-like lesions from triamcinolone acetonide. Contact Dermatitis 1998; 38:362-3.
  • https://doi.org/10.1111/j.1600-0536.1998.tb05795.x
  • calista d, Schianchi S. Erythema multiforme-like eruption induced by contact dermatitis caused by topi- cal corticosteroids. G Ital Dermatol Venereol 2008; 143:227-8.
  • Baeck m, chemelle J A, Goossens A, Nicolas J F, Terreux R. Corticosteroids cross-reactivity: clinical and molecular modeling tools. Allergy 2011; 66(10):1367-74.
  • https://doi.org/10.1111/j.1398-9995.2011.02666.x
  • matura m, lepoittevin JP, Arbez Gindre c, Goossens A. Testing with corticosteroid aldehydes in corticosteroid sensitive patients (preliminary results). Contact Dermatitis 1998;38:106-8.
  • https://doi.org/10.1111/j.1600-0536.1998.tb05663.x
  • Fonacier l, Sher J. Allergic contact dermatitis. Ann Allergy Asthma Immunol 2014;113:9-12.
  • https://doi.org/10.1016/j.anai.2014.03.018
  • Boffa mJ, Wilkinson Sm, Beck mH. Screening for corticosteroid contact hypersensitivity. Contact Dermatitis 1995;33:149-51.
  • https://doi.org/10.1111/j.1600-0536.1995.tb00535.x
  • Schalock P, dunnick c, Nedorost S, Brod B, Warshaw e, mowad c. American Contact Dermatitis Society Core Allergen Series. Dermatitis 2013;24:7.
  • https://doi.org/10.1097/DER.0b013e318281d87b
  • Baeck m, chemelle J-AA, Terreux R, drieghe J, Goossens A. Delayed hypersensitivity to corticostero- ids in a series of 315 patients:clinical data and patch test results. Contact Dermatitis 2009;61:163-75.
  • https://doi.org/10.1111/j.1600-0536.2009.01602.x
  • Pereira F, cunha H, dias m. Contact dermatitis due to emulsifiers. Contact Dermatitis 1997;36:114.
  • https://doi.org/10.1111/j.1600-0536.1997.tb00432.x
  • Soria A, Baeck m, marot l, duveiller V, derouaux A S, Nicolas JF, Goossens A, et al. Patch, prick, or intradermal tests to detect delayed hypersensitivity to corticosteroids? Contact Dermatitis 2011:64:313-24.
  • https://doi.org/10.1111/j.1600-0536.2011.01888.x

Corticosteroid-Related Allergic Reactions

Year 2017, , 4 - 11, 01.01.2017

Pınar Gökmirza Özdemir Mehtap Yazıcıoğlu

https://doi.org/10.5222/j.child.2017.004

Abstract

Corticosteroids are being used prevalently in the whole world due to their antiinflammatory effects. The reactions which are related to their pharmacological properties and their metabolic side effects are well known. But they can also cause hypersensitivity reactions independent from these characteristics. They are commonly used in allergic diseases and the hypersensitivity reactions related to corticosteroids are often misinterpreted as the reaction related to the underlying disease, and mostly overlooked In this article, molecular structures of corticosteroids and related classification, clinical findings, diagnosis, and treatment of allergic reactions caused by immunological mechanisms induced by corticosteroids.

Keywords

Corticosteroid allergy contact dermatitis

References

  • Baeck m, Nicolas JF, Pilette c, Tennstedt d, Goossens A. Allergic hypersensitivity to topical and systemic cor- ticosteroids: a review. Allergy 2009;64:978-94.
  • https://doi.org/10.1111/j.1398-9995.2009.02038.x
  • Baeck m, Goossens A. Immediate and delayed allergic hypersensitivity to corticosteroids: practical guidelines. Contact Dermatitis 2012;66(1):38-45.
  • Baker A, empson m, The R, Fitzharris P. Skin tes- ting for immediate hypersensitivity to corticosteroids: a case series and literature review. Clin Exp Allergy 2015;45:669-76.
  • https://doi.org/10.1111/cea.12441
  • otani ım, Banerji A. Immediate and delayed hyper- sensitivity reactions to corticosteroids: Evaluation and management. Curr Allergy Asthma Rep 2016;16(3):18.
  • https://doi.org/10.1007/s11882-016-0596-7
  • compalati e, Guerra l, Rogkakou A, zanella c, Scordamaglia A, Passalacqua G. Angioedema after administration of methylprednisolone to treat drug allergy. Allergy 2007;62:1346-8.
  • currie G, Paterson e, Keenan F, Nath S, Watt S. An unexpected response to intravenous hydrocortisone succinate in an asthmatic patient. Br J Clin Pharmacol 2005;60:342.
  • caimmi S, caimmi d, Bousquet PJ, demoly P. Succinate as opposed to glucocorticoid itself allergy. Allergy 2008;63:1641-3.
  • Gelincik A, Yazici H, emre T, Yakar F, Buyukozturk S. An alternative approach to a renal transplant patient who experienced an immediate type systemic reaction due to methylprednisolone sodiumsuccinate. J Investig Allergol Clin Immunol 2009;19:162-3.
  • Koutsostathis N, Vovolis V. Severe immunoglobulin E-mediated anaphylaxis to intravenous methylpredni- solone succinate in a patient who tolerated oral methy- lprednisolone. J Investig Allergol Clin Immunol 2009;19:330-2.
  • Walker Aı, Räwer H-c, Sieber W, Przybilla B. Immediate-type hypersensitivity to succinylated corti- costeroids. Int Arch Allergy Immunol 2010;155:86-92.
  • https://doi.org/10.1159/000318678
  • Kamm Gl, Hagmeyer Ko. Allergic- type reactions to corticosteroids. Ann Pharmacother 1999;33:451-60.
  • https://doi.org/10.1345/aph.18276
  • Nowak-Wegrzyn A, Shapiro G, Beyer K, Bardina l, Sampson H. Contamination of dry powder inhalers for asthma with milk proteins containing lactose. J Allergy Clin Immunol 2004;113:558-60.
  • https://doi.org/10.1016/j.jaci.2003.11.015
  • eda A, Sugai K, Shioya H, Fujitsuka A, ıto S, ıwata T, et al. Acute allergic reaction due to milk proteins contaminating lactose added to corticosteroid for injec- tion. Allergol Int 2009;58:137-9.
  • https://doi.org/10.2332/allergolint.C-07-59
  • Savvatianos S, Giavi S, Stefanaki e, Siragakis G, manousakis e, Papadopoulos NG. Cow’s milk allergy as a cause of anaphylaxis to systemic corticosteroids. Allergy 2011;66:983-5.
  • https://doi.org/10.1111/j.1398-9995.2011.02566.x
  • levyY, Segal N, Nahum A, marcus N, Garty B-z. Hypersensitivity to methylprednisolone sodium succi- nate in children with milk allergy. J Allergy Clin Immunol In Pract 2014;2:471-4.
  • https://doi.org/10.1016/j.jaip.2014.03.002
  • Venturini m, lobera T, del Pozo md, González ı, Blasco A. Immediate hypersensitivity to corticostero- ids. J Investig Allergol Clin Immunol 2006;16:51-6.
  • muroi N, Nishibori m, Fujii T, Yamagatam, Hosoi S, Nakaya N, et al. Anaphylaxis from the carboxy- methylcellulose component of barium sulfate suspensi- on. N Engl J Med 1997;337:1275-7.
  • https://doi.org/10.1056/NEJM199710303371804
  • Bigliardi Pl, ızakovic J,Weber Jm, Bircher A. Anaphylaxis to the carbohydrate carboxymethylcellu- lose in parenteral corticosteroid preparations. Dermatology 2003;207:100-3.
  • https://doi.org/10.1159/000070958
  • Field S, Falvey e, Barry J, Bourke J. Type 1 hyper- sensitivity reaction to carboxymethylcellulose follo- wing intra articular triamcinolone injection. Contact Dermatitis 2009;61:302-3.
  • https://doi.org/10.1111/j.1600-0536.2009.01636.x
  • dewachter P, mouton-Faivre c. Anaphylaxis to mac- rogol 4000 after a parenteral corticoid injection. Allergy 2005;60:705-6.
  • https://doi.org/10.1111/j.1398-9995.2005.00783.x
  • Sohy c, Vandenplas o, Sibille Y. Usefulness of oral macrogol challenge in anaphylaxis after intra articular injection of corticosteroid preparation. Allergy 2008;63:478-9.
  • https://doi.org/10.1111/j.1398-9995.2007.01610.x
  • Borderé A, Stockman A, Boone B, Franki A, coppens m, lapeere H, et al. A case of anaphylaxis caused by macrogol 3350 after injection of a corticos- teroid. Contact Dermatitis 2012;67:376-8.
  • https://doi.org/10.1111/j.1600-0536.2012.02104.x
  • Patel A, Bahna S. Immediate hypersensitivity reacti- ons to corticosteroids. Ann Allergy Asthma Immunol 2015;115:178-82.
  • https://doi.org/10.1016/j.anai.2015.06.022
  • Ventura mT, calogiuri GF, muratore l et al. Cross- reactivity in cell-mediated and IgE-mediated hypersen- sitivity to corticosteroids. Curr Pharm Des 2006:12: 3383-91.
  • https://doi.org/10.2174/138161206778194006
  • Pryse-Phillips We, chandra RK, Rose B. Anaphylactoid reaction to methylprednisolone pulsed therapy for multiple sclerosis. Neurology 1984;34:1119- 21.
  • https://doi.org/10.1212/WNL.34.8.1119
  • Rodrigues-Alves R, Spínola-Santos A, Pedro e, Branco-Ferreira m, Pereira-Barbosa m. Immediate hypersensitivity to corticosteroids: finding an alternati- ve. J Investig Allergol Clin Immunol 2007;17:284-5.
  • matura G. Contact allergy to corticosteroids. Allergy 2000;55:698-704.
  • https://doi.org/10.1034/j.1398-9995.2000.00121.x
  • Skoet R, zachariae R, Agner T. Contact dermatitis and quality of life: a structured review of the literature. Br J Dermatol. 2003;149:452–6.
  • https://doi.org/10.1046/j.1365-2133.2003.05601.x
  • Baeck m, chemelle J A, Rasse c,Terreux R, Goossens A. C16-methylated corticosteroids are less far allergenic than the non-methylated molecules. Contact Dermatitis 2011;64:305-12.
  • https://doi.org/10.1111/j.1600-0536.2011.01874.x
  • Baeck m, Goossens A. Patients with airborne sensiti- zation/contact dermatitis from budesonide-containing aerosols ‘by proxy’. Contact Dermatitis 2009:1:1-8.
  • https://doi.org/10.1111/j.1600-0536.2009.01575.x
  • malik m, Tobin A m, Shanahan F,o’morain c, Kirby B, Bourke J. Steroid allergy in patients with inflammatory bowel disease. Br J Dermatol 2007;157:967-9.
  • miranda Romero A, Sánchez Sambucety P, Bajo c, martinez m, Garcia munoz m. Genital oedema from contact allergy to prednicarbate. Contact Dermatitis 1998;38:228.
  • https://doi.org/10.1111/j.1600-0536.1998.tb05725.x
  • Valsecchi R, Reseghetti A, leghissa P, cologni l, cortinovis R. Erythema-multiforme-like lesions from triamcinolone acetonide. Contact Dermatitis 1998; 38:362-3.
  • https://doi.org/10.1111/j.1600-0536.1998.tb05795.x
  • calista d, Schianchi S. Erythema multiforme-like eruption induced by contact dermatitis caused by topi- cal corticosteroids. G Ital Dermatol Venereol 2008; 143:227-8.
  • Baeck m, chemelle J A, Goossens A, Nicolas J F, Terreux R. Corticosteroids cross-reactivity: clinical and molecular modeling tools. Allergy 2011; 66(10):1367-74.
  • https://doi.org/10.1111/j.1398-9995.2011.02666.x
  • matura m, lepoittevin JP, Arbez Gindre c, Goossens A. Testing with corticosteroid aldehydes in corticosteroid sensitive patients (preliminary results). Contact Dermatitis 1998;38:106-8.
  • https://doi.org/10.1111/j.1600-0536.1998.tb05663.x
  • Fonacier l, Sher J. Allergic contact dermatitis. Ann Allergy Asthma Immunol 2014;113:9-12.
  • https://doi.org/10.1016/j.anai.2014.03.018
  • Boffa mJ, Wilkinson Sm, Beck mH. Screening for corticosteroid contact hypersensitivity. Contact Dermatitis 1995;33:149-51.
  • https://doi.org/10.1111/j.1600-0536.1995.tb00535.x
  • Schalock P, dunnick c, Nedorost S, Brod B, Warshaw e, mowad c. American Contact Dermatitis Society Core Allergen Series. Dermatitis 2013;24:7.
  • https://doi.org/10.1097/DER.0b013e318281d87b
  • Baeck m, chemelle J-AA, Terreux R, drieghe J, Goossens A. Delayed hypersensitivity to corticostero- ids in a series of 315 patients:clinical data and patch test results. Contact Dermatitis 2009;61:163-75.
  • https://doi.org/10.1111/j.1600-0536.2009.01602.x
  • Pereira F, cunha H, dias m. Contact dermatitis due to emulsifiers. Contact Dermatitis 1997;36:114.
  • https://doi.org/10.1111/j.1600-0536.1997.tb00432.x
  • Soria A, Baeck m, marot l, duveiller V, derouaux A S, Nicolas JF, Goossens A, et al. Patch, prick, or intradermal tests to detect delayed hypersensitivity to corticosteroids? Contact Dermatitis 2011:64:313-24.
  • https://doi.org/10.1111/j.1600-0536.2011.01888.x
There are 74 citations in total.

Details

Primary Language Turkish
Journal Section Research Articles
Authors

Pınar Gökmirza Özdemir This is me

Mehtap Yazıcıoğlu This is me

Publication Date January 1, 2017
Published in Issue Year 2017

Cite

APA Gökmirza Özdemir, P., & Yazıcıoğlu, M. (2017). Kortikosteroidler ile İlişkili Alerjik Reaksiyonlar. Çocuk Dergisi, 17(1), 4-11. https://doi.org/10.5222/j.child.2017.004
AMA Gökmirza Özdemir P, Yazıcıoğlu M. Kortikosteroidler ile İlişkili Alerjik Reaksiyonlar. Çocuk Dergisi. January 2017;17(1):4-11. doi:10.5222/j.child.2017.004
Chicago Gökmirza Özdemir, Pınar, and Mehtap Yazıcıoğlu. “Kortikosteroidler Ile İlişkili Alerjik Reaksiyonlar”. Çocuk Dergisi 17, no. 1 (January 2017): 4-11. https://doi.org/10.5222/j.child.2017.004.
EndNote Gökmirza Özdemir P, Yazıcıoğlu M (January 1, 2017) Kortikosteroidler ile İlişkili Alerjik Reaksiyonlar. Çocuk Dergisi 17 1 4–11.
IEEE P. Gökmirza Özdemir and M. Yazıcıoğlu, “Kortikosteroidler ile İlişkili Alerjik Reaksiyonlar”, Çocuk Dergisi, vol. 17, no. 1, pp. 4–11, 2017, doi: 10.5222/j.child.2017.004.
ISNAD Gökmirza Özdemir, Pınar - Yazıcıoğlu, Mehtap. “Kortikosteroidler Ile İlişkili Alerjik Reaksiyonlar”. Çocuk Dergisi 17/1 (January 2017), 4-11. https://doi.org/10.5222/j.child.2017.004.
JAMA Gökmirza Özdemir P, Yazıcıoğlu M. Kortikosteroidler ile İlişkili Alerjik Reaksiyonlar. Çocuk Dergisi. 2017;17:4–11.
MLA Gökmirza Özdemir, Pınar and Mehtap Yazıcıoğlu. “Kortikosteroidler Ile İlişkili Alerjik Reaksiyonlar”. Çocuk Dergisi, vol. 17, no. 1, 2017, pp. 4-11, doi:10.5222/j.child.2017.004.
Vancouver Gökmirza Özdemir P, Yazıcıoğlu M. Kortikosteroidler ile İlişkili Alerjik Reaksiyonlar. Çocuk Dergisi. 2017;17(1):4-11.