[Allergic manifestations of nickel allergy in women with copper IUDs] Allergiske manifestationer pga. nikkeloverfolsomhed hos kvinder med kobberspiral.
Copper IUDs contain a mixture of metals, of which copper naturally is the major component. The remainder are other metals, among them nickel (.0025% nickel in the CuT-200 IUD with a total copper contact of 200 mg). Although the release of nickel from the IUD is extremely small, it is work bearing in mind that nickel may be the source of allergic complications with the use of such IUDs. The Danish health ministry received a total of 5 reports of allergic skin reactions to copper spiral IUDs during the period 1968-1988; 4 of these women developed exanthema; 1 of these women also developed pruritus; and 1 woman developed acne vulgaris. Common to all 5 women was the fact that their skin symptoms occurred in immediate reaction to the insertion of a spiral and disappeared when it was removed. The case history at hand concerns a young women with long-standing allergic symptoms including asthma, Besnier's pruritus and eczema. Allergic evaluation demonstrated allergies for many environmental factors including nickel and rubber but did not show allergy for copper. Following a leg thrombosis while on oral contraceptives, she switched to a copper spiral for a period of 2 years. When the copper spiral was removed, skin and abdominal symptoms cleared up quickly. She was later fitted with a Lippes loop, which does not contain copper. The symptoms did not reappear. Since all IUDs marketed in Denmark now contain copper, the author recommends that the Danish health ministry permit the important of Lippes loops for use in individual cases where allergic reaction to the nickel content of the IUD is suspected.