[滴眼液引起过敏性休克的临床病例]。

Iván Tinoco-Moran, Oscar Calderón-Liosa, Margarita Olivares-Gómez, Victor Farinango-Salazar, Iván Chérrez-Ojeda
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引用次数: 0

摘要

背景:过敏性休克是一种严重的全身性过敏反应,可危及生命:过敏性休克是一种严重的全身性过敏反应,可危及生命,这些患者需要及时诊断和治疗,而最常见的诱发因素之一是药物:目的:报告一例因滴眼药水引起过敏性休克的患者:患者为一名 7 岁男性,有鼻炎和哮喘病史,病情控制良好。病例报告:一名 7 岁男性,有鼻炎和哮喘病史,病情控制良好:15 分钟后出现过敏性休克,最初表现为瘙痒和强烈的结膜红斑,随后又出现恶心、呕吐、出汗、虚弱、荨麻疹/面部血管性水肿和呼吸困难等症状,随后使用左西替利嗪 5 毫克舌下含服和倍他米松 4 毫克肌肉注射,病情在接下来的 2 小时内逐渐好转。过敏科医生对患者进行了评估,并向其母亲提出了书面建议,以防再次出现这种反应,同时禁止使用滴眼液,并等待进行皮试和可能的结膜刺激试验。2 个月后,患者再次意外接触了同样的滴眼液,在用药 15 分钟后出现了类似的反应,他们前往急诊室,接受了抗组胺药和皮质类固醇的静脉注射治疗:我们介绍了一例使用滴眼液后发生结膜过敏性休克的病例,再次接触药物后证实了这一点。诊断、建议治疗和避免使用可能诱发过敏反应的药物至关重要。当这些患者开始出现过敏反应时,立即给他们用药至关重要,如果他们住得离医疗中心很远,就更有必要了。
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[Clinical case of anaphylaxis due to eye drops].

Background: Anaphylaxis is a severe systemic allergic reaction that can be life-threatening, timely diagnosis and treatment is required in these patients, one of the most frequent triggers is pharmacological.

Objective: To report the case of a patient who presented anaphylaxis due to eye drops.

Case report: A 7-year-old male with a history of rhinitis and asthma with good control. It started with itchy eyes, ophthalmic drops were administered, composition: Polyethylene glycol 400, 0.4%, Propylene glycol 3 mg, polyquad 0.001%, presenting at 15 minutes an episode of anaphylaxis initially characterized by pruritus and intense conjunctival erythema, later nausea, vomiting, sweating, weakness, urticaria/facial angioedema and dyspnea were added, this episode was controlled opportunely with Levocetirizine 5 mg sublingual and Betametasona 4 mg intramuscular, progressively improving over the next 2 hours. The patient was evaluated by the Allergist, written recommendations were given to the mother in case this reaction occurred again, the use of the drops was prohibited, and the performance of skin test and a probable conjunctival provocation protocolized with the ophthalmic drops were pending. Accidentally 2 months later the patient was re-exposed with the same eye drops, presenting a similar reaction 15 minutes after the administration of the medication, they went to the emergency room where he received antihistamine and corticosteroid intravenous treatment, after this re-exposure is confirmed to the ophthalmic drops mentioned above as a trigger of anaphylaxis in this patient.

Conclusions: We present a case of conjunctival anaphylaxis after application of eye drops, confirmed by re-exposure to the drug. It is essential to give diagnoses, recommendations with treatments and avoidance of the probable triggering agent of the reaction. The administration of immediate medication when the allergic episode begins in these patients can be vital, even more so when they live far from a health center, as was the case in this patient.

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