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双氯芬酸诱发过敏反应:尼泊尔的一例病例报告。

Diclofenac induced anaphylaxis: A case report from Nepal.

作者信息

Bhattarai Himal Bikram, Shah Sangam, Uprety Manish, Baniya Santosh, Maharjan Gyabina, Priya Anshu, Singh Prabesh Bikram, Subedi Ayusha

机构信息

Gandaki Medical College and Teaching Hospital, Pokhara, Nepal.

Tribhuvan University, Institute of Medicine, Maharajgunj, 44600, Nepal.

出版信息

Ann Med Surg (Lond). 2022 Jul 31;80:104233. doi: 10.1016/j.amsu.2022.104233. eCollection 2022 Aug.

Abstract

INTRODUCTION

Diclofenac is considered a generally safe medication, and cause few side effects like dyspepsia, diarrhea/constipation, nausea, and vomiting, stomach bleeding, rash, urticaria, photosensitivity reactions, acute renal failure, analgesic nephropathy, bone marrow and liver diseases. Rarely, it causes anaphylactic reaction.

CASE PRESENTATION

We report a case of 40 years male who developed anaphylactic reaction after intravenous infusion with diclofenac.

DISCUSSION

Both the pulmonary embolism and anaphylaxis guidelines emphasize the importance of a thorough evaluation when making a diagnosis. Mast cells secrete tryptase, a neutral protease that is specifically concentrated in the secretory granules of human mast cells (but not basophils), along with histamine, as a marker of mast cell activation.

CONCLUSION

Although intravenous diclofenac sodium is a safe and often used medicine, it can cause severe and perhaps fatal anaphylactic responses.

摘要

引言

双氯芬酸被认为是一种总体安全的药物,很少引起副作用,如消化不良、腹泻/便秘、恶心、呕吐、胃出血、皮疹、荨麻疹、光敏反应、急性肾衰竭、止痛药性肾病、骨髓和肝脏疾病。极少情况下,它会引起过敏反应。

病例报告

我们报告一例40岁男性在静脉输注双氯芬酸后发生过敏反应的病例。

讨论

肺栓塞和过敏反应指南都强调在做出诊断时进行全面评估的重要性。肥大细胞分泌类胰蛋白酶,这是一种中性蛋白酶,与组胺一起特异性地集中在人类肥大细胞(而非嗜碱性粒细胞)的分泌颗粒中,作为肥大细胞活化的标志物。

结论

尽管静脉注射双氯芬酸钠是一种安全且常用的药物,但它可能会引起严重甚至致命的过敏反应。

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本文引用的文献

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Fatal anaphylactic reaction to diclofenac.
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