Anaphylactic reaction induced by homeotoxic Drug
Authors: Marsella, Sofía., Naime, Martha., Parada, Elizabeth.
Female patient, 57 years old, with NSAIDs allergy history, who after the homeopathic drug administration (Reumatric®) presented: laryngeal stridor, generalized skin rash, severe respiratory distress which needed cardiopulmonary resuscitation, sphincter relaxation and loss of consciousness; she is moved by her family on 16/08/1910 to Santa Ana medical center, the patient was admitted in poor general conditions, swollen, facial erythema, acrocyanosis and chest pain treated with sublingual Isordil, with blood pressure: 159/89 mmHg, heart rate: 110 bpm, respiratory rate: 18 bpm, with paraclinical tests: Hb: 13,6 gr/dl, Wbc: 22400 cells/µl, Het: 45%, Lym: 55%, Plt: 182000, PT and PTT within normal limits, pH:7,44; PCo: 29,7; PO2: 150; HCO3: 20,5; SatO2: 99% (with O2 by mask to 6 l/min); fibrinogen: 291 mg/l; Urea: 47,6 mg/l; Creatinine: 1,23 mg/l; troponins: I: 0,06; T: 0,03. She was admitted to intensive care unit with this diagnosis: 1) anaphylactic shock, 2) hypersensitivity reaction, 3) Ischemic cardiopathy. Advanced supportive measures were applied for 48 hours with satisfactory evolution. Paraclinical tests 18/08/10: Hb: 11,6 gr/dl, Wbc: 14100 cells/µl, Het: 81%, Lym: 18%, Plt: 212000, PT and PTT within normal limits, Urea: 43,5 mg/l; Creatinine: 0,91 mg/l, glucose: 150,9 mg/dl, CK: 535 U/l; CKMB: 48 U/l; TGO: 79,6 U/L; TGP: 51,4 U/l; Na: 131,5 mmol/l; K: 5,59 mmol/l; Cl: 106,2 mmol/l; Troponins: I: 10,17; T: 0,40. She was under hospitalization for 3 days. 21/08/10 is discharged later to cardiology and immunology evaluation with this diagnosis: Severe anaphylactic shock for homeotoxic drug (Reumatric®), complicated with ischemic myocardial injury in recovery.