Delayed anaphylactic shock and rash due to indomethacin suppository

Abstract

An 81-year-old female patient received indomethacin suppository 3 times within 30 hours because of fever (the first time use was permitted by physician, the other 2 times of use were decided by herself), one piece (100 mg) at each time. Forty hours after the first use of indomethacin suppository and 10 hours after the last use of the medicine, the patient developed symptoms of shock like sweating, dyspnea, nausea, cyanosis of lips, convulsions, loss of consciousness, no response to sound and lower blood pressure together with erythema and maculopapule with pruritus over the whole body. It was considered that indomethacin suppository induced the delayed anaphylactic shock and rashes. Oxygen inhalation, IV infusion of 5% glucose solution 250 ml, 1.0 g calcium gluconate+ 2.0 g vitamin C+ glucose and sodium chloride for injection 500 ml were given immediately. About 1 hour later, her symptoms of shock relieved. Indomethacin suppository was withdrawn and anti-allergy therapy was continued. Six days later, her erythema and papular rashes disappeared. Key words: Indomethacin; Hypersensitivity, delayed