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""Although corticosteroids are broadly used to treat asthma and allergic disorders, steroids themselves, however, can induce hypersensitivity reactions (IHS) (1). We present the first case of anaphylactic shock reaction due to intra-venous methylprednisolone (MP) that occurred during anaesthesia, with positive skin tests and positive basophil activation test (BAT). Tolmetin In July 2007, an 18-year-old female patient experienced anaphylactic shock during general anaesthesia for a dental extraction [tryptase: 38 (N?20s Proteasome activity (control 2%). The BAT was negative in two healthy volunteers. We performed a corticoid battery of skin tests and found a positive cross-reaction with hydrocortisone, while the prick and IDT tests were negative for prednisone, betamethasone, prednisolone and beclomethasone. The BAT with prednisone was negative. Carboxymethylcellulose (CMC) was not tested in our case. In June 2008, the patient was challenged with prednisone in intensive care unit without allergic reaction. Severe IgE mediated anaphylaxis after intra-venous corticosteroids injection occurs in 0.1% of the patients (2). Corticosteroids have been classified in four reactivity groups (A, B, C and D) based on their structural and clinical characteristics. learn more Our observation suggests that skin tests could be useful for the diagnosis of MP IHS. Carboxymethylcellulose is a carbohydrate widely used as an additive in tablets, cosmetics, some injectable hormone formulations and food. Anaphylaxis to CMC in corticosteroid preparations has been reported (3). However, in our case, there was a cross reactivity with hydrocortisone, which does not contain CMC and excluded a CMC immediate hypersensitivity. Skin tests sensibility for MP anaphylaxis is unknown, but several observations have shown that they could be of interest (2). We have found cross reactivity between MP and hydrocortisone, and two drugs belonging to the A group of corticosteroids, which are frequently involved in corticosteroids IHS. Nevertheless, our patient did tolerate prednisolone, another group A steroid, as previously described (4). Interestingly, the BAT was also positive confirming the patient IgE mediated MP hypersensitivity.