Recurrent losses of consciousness in anaphylactic reactions

Abstract

Within one year a 36-year-old man had three episodes of loss of consciousness associated with a fall in blood pressure. No cause was established despite repeated hospital admissions. But an anaphylactic reaction was suspected as the cause after yet another syncope when the administration of antihistamines and steroids had quickly improved the patient's state. In retrospect it became clear that the loss of consciousness had occurred after the eating of bananas. Total IgE level was 695 kU/l and there was marked sensitization to bananas (IgE radio-allergosorbent test [RAST] class 2) and latex (IgE RAST class 2), confirmed by marked immediate-type reactions to these substances in the prick test. Dietary advice was given and the significance of the latex sensitization explained. The patient was given an allergy pass and drugs for emergency use. Anaphylactic reaction should be included in the differential diagnosis of loss of consciousness of uncertain cause. The prognosis of such a reaction is excellent only if treated at once. Both diagnosis and treatment are relatively simple.