Immediate anaphylaxis caused by folic acid tablets
10.3760/cma.j.cn114015-20190410-00352
- VernacularTitle:叶酸片致速发型过敏反应
- Author:
Ruipeng GUO
1
;
Guoxiang ZHANG
1
Author Information
1. 长治医学院附属和平医院血液科 046000
- Publication Type:Journal Article
- Keywords:
Hypersensitivity;
Folic acid;
Anemia, megaloblastic;
Folic acid deficiency
- From:
Adverse Drug Reactions Journal
2020;22(7):416-417
- CountryChina
- Language:Chinese
-
Abstract:
A 46-year-old female patient with rheumatoid arthritis received oral folic acid 10 mg thrice daily for nutritional megaloblastic anemia. About 8 minutes after the first administration, the patient developed itchy skin all over the body, followed by diffuse macular papules on the head, face, limbs, and trunk. Considering the immediate anaphylaxis caused by folic acid, folic acid was discontinued and chlorphenamine 4 mg was given orally. However, her skin symptoms were aggravated, followed by shortness of breath, chest tightness, nausea, and etc. Symptomatic treatments with dexamethasone, 10% calcium gluconate, promethazine, and oxygen inhalation were given immediately. Forty minutes later, her itchy skin was relieved; 5 hours later, the rashes subsided; and 7 hours later, the allergic symptoms disappeared. After 3 days of treatment with chlorphenamine, folic acid desensitization treatment was performed. Then no adverse reactions recurred and the patient′s anemia was gradually improved. The patient continued to took oral loratadine and folic acid. At 1 month of follow-up, she had no discomfort, and the laboratory tests showed hemoglobin 113.5 g/L. Drugs were stopped and the patient was instructed to visit the department of rheumatology for the treatment of rheumatoid arthritis.
