Diclofenac induced anaphylaxis: A case report from Nepal. (August 2022)

• Record Type: Journal Article
• Authors: Bhattarai, Himal Bikram; Shah, Sangam; Uprety, Manish; Baniya, Santosh; Maharjan, Gyabina; Priya, Anshu; Singh, Prabesh Bikram; Subedi, Ayusha
• Is Part Of: Annals of medicine and surgery. Volume 80(2022)
• Publication Date: 2022-08
• Subjects: Diclofenac -- Anaphylaxis -- Intravenous; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.104233
• Languages: English
• ISSNs: 2049-0801

Abstract

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. Highlights: IV diclofenac sodium can cause fatal anaphylactic responses. It might mimic pulmonary embolism in symptoms. Accurate and timely diagnosis of anaphylaxis and withheld of diclofenac should be done.