Ouchi Shohei, Ogiyama Hideharu, Tsutsui Shusaku, Nasu Ayaka, Seto Kayo, Horiki Masashi, Sanomura Tamana, Imanaka Kazuho, Murayama Yoko, Iishi Hiroyasu
Department of Gastroenterology and Hepatology, Itami City Hospital.
Department of Gastroenterology and Hepatology, NTT West Osaka Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2019;116(4):330-335. doi: 10.11405/nisshoshi.116.330.
A 44-year-old man was administered Niflec containing macrogol 4000 as a bowel cleanser for colonoscopic examination. Immediately after ingestion, he experienced oral cavity discomfort and nasal congestion, followed by acute urticaria and presyncope. His systolic blood pressure and peripheral capillary oxygen saturation dropped to 66mmHg and 89%, respectively. Fluid infusion, as well as steroid and epinephrine administration, improved his symptoms. Skin prick tests were then performed using Niflec, macrogol 4000, and Actosin ointment (containing macrogol 4000), all of which were positive. Therefore, the patient was diagnosed with anaphylactic shock caused by macrogol 4000 included in Niflec. Macrogol present in bowel cleansers used for colonoscopy rarely causes anaphylactic shock. However, clinicians need to be mindful of this risk. Prompt and appropriate treatment is needed should this condition occur.
一名44岁男性在接受含有聚乙二醇4000的Niflec作为结肠镜检查的肠道清洁剂后，服药后立即出现口腔不适和鼻塞，随后出现急性荨麻疹和晕厥前症状。他的收缩压和外周毛细血管血氧饱和度分别降至66mmHg和89%。输液以及使用类固醇和肾上腺素后症状有所改善。随后使用Niflec、聚乙二醇4000和Actosin软膏（含聚乙二醇4000）进行皮肤点刺试验，结果均为阳性。因此，该患者被诊断为由Niflec中含有的聚乙二醇4000引起的过敏性休克。用于结肠镜检查的肠道清洁剂中含有的聚乙二醇很少引起过敏性休克。然而，临床医生需要注意这种风险。如果发生这种情况，需要及时进行适当治疗。
