Abstract
BackgroundThere have been only few reports on butylscopolamine-induced anaphylaxis despite its global usage as an anticholinergic agent for approximately 70 years. We present a case of anaphylaxis caused by butylscopolamine.Case presentationA 63-year-old woman underwent gastrointestinal endoscopic examination. She developed facial cyanosis and hypoxia after intravenous administration of butylscopolamine 10 mg, and her blood pressure was unmeasurable. Her hemodynamic condition recovered after a total of 0.6 mg adrenaline and bolus administration of 100 mg hydrocortisone. One hour after the onset of hypotension, both plasma histamine and serum tryptase were remarkably elevated to 271.7 nmol/L and 174 μg/L, respectively. Skin tests performed 47 days after anaphylaxis showed a positive result only for butylscopolamine among the exposed agents, which was confirmed by basophil activation tests using CD203c and CD63 as markers.ConclusionButylscopolamine has the potential to cause severe anaphylaxis; hence, identification of the causative agent is important to prevent recurrence of anaphylaxis.
Highlights
There have been only few reports on butylscopolamine-induced anaphylaxis despite its global usage as an anticholinergic agent for approximately 70 years
We describe the case of a 63-yearold woman who developed anaphylactic shock during gastroscopy, which was diagnosed as butylscopolamine bromide-induced anaphylaxis
* Correspondence: takazawt@gunma-u.ac.jp 3Intensive Care Unit, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan Full list of author information is available at the end of the article for all drugs, for drugs with few clinical reports of anaphylaxis, such as butylscopolamine bromide
Summary
There have been only few reports on butylscopolamine-induced anaphylaxis despite its global usage as an anticholinergic agent for approximately 70 years. * Correspondence: takazawt@gunma-u.ac.jp 3Intensive Care Unit, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan Full list of author information is available at the end of the article for all drugs, for drugs with few clinical reports of anaphylaxis, such as butylscopolamine bromide. Plasma histamine and serum tryptase levels were measured immediately after the incident, confirming the occurrence of anaphylaxis.
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