Sodium chloride
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Anaphylaxis: case report A 37-year-old woman developed anaphylaxis after receiving an IV sodium chloride infusion [isotonic saline; dosage not clearly stated]. The woman, who was being followed-up for an ovarian cyst, presented with a 5-hour history of abdominal pain, which was preceded by nausea and vomiting; her medical history was significant for two ovarian cyst operations, a laparoscopic cholecystectomy, in vitro fertilisation, atopy and allergic reactions to atropine, pheniramine and radiocontrast agents. Her concomitant medications included corticosteroids for atopy, and an oral contraceptive. At presentation, her BP and pulse rate were 140/80mm Hg and 100 beats/min, respectively. During withdrawal of blood samples, she started receiving an IV sodium chloride infusion containing metoclopramide. After a few minutes, she reported palpitations and vertigo. Her BP and pulse rate were 100/60mm Hg and 140 beats/min, respectively. Intravenous fluid administration was stopped. Auscultation showed diffuse rhonchi. Metoclopramide was suspected. Investigations ruled out ovarian cyst rupture and the woman had normal results for abdominal ultrasound and CT scan. Sodium chloride solution was restarted without any medication in it and, after a few minutes, she again reported palpitations and vertigo along with chest distress. She developed syncope and her pulse rate increased to 150 beats/min. She also developed erythema over her neck and thorax and rhonchi in her lungs. Sodium chloride infusion was stopped and she immediately showed improvement. Sodium chloride was restarted and she again reported similar symptoms. Her symptoms did not recur with 5% dextrose solution. She was subsequently discharged and, 2 months later, she reported that she had undergone an operation for her ovarian cyst, during which she had developed similar symptoms following sodium chloride administration. Ay D, et al. An unusual cause of allergy: case report of normal saline solution allergy. American Journal of Emergency Medicine 27: 130.e1-130.e2, No. 1, Jan 801124913 2009. Available from: URL: http://www.ajemjournal.com - Turkey
0114-9954/10/1232-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 13 Dec 2008 No. 1232
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