Delayed hypersensitivity reaction after intravenous glucagon administered for a barium enema: a case report.
- Author:
Ching Yin NEOH
1
;
Audrey W H TAN
;
Yung Hian LEOW
Author Information
- Publication Type:Case Reports
- MeSH: Adrenal Cortex Hormones; therapeutic use; Aged; Barium Compounds; Drug Hypersensitivity; etiology; Enema; Female; Glucagon; administration & dosage; adverse effects; Histamine H1 Antagonists; therapeutic use; Humans; Hypersensitivity, Delayed; etiology; Injections, Intravenous; Parasympatholytics; administration & dosage; adverse effects; Time Factors
- From:Annals of the Academy of Medicine, Singapore 2006;35(4):279-281
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONFew reports have documented allergic hypersensitivity reactions after barium gastrointestinal studies. Of these, the barium suspension, its additives or intravenous glucagon given for bowel relaxation has been implicated as possible allergens. We report a patient with delayed hypersensitivity reaction after barium enema and discuss the reasons supporting glucagon as the possible allergen.
CLINICAL PICTUREA 74-year-old Chinese woman presented with pruritic rashes, 1 day after a barium enema. Intravenous glucagon (GlucaGen, Novo Nordisk, Denmark) was administered during the barium enema. Physical examination revealed palpable purpuric rashes on the legs with erythematous papules and plaques on the arms and trunk. Skin biopsy demonstrated superficial perivascular infiltrates of lymphocytes and eosinophils, consistent with a drug eruption.
TREATMENT AND OUTCOMEThe rashes resolved with antihistamines and topical corticosteroids.
CONCLUSIONThis report highlights the potential of glucagon to cause hypersensitivity reactions. Awareness of this entity is important for the prevention and recognition of complications during barium gastrointestinal studies.
