A 60-year-old male patient was treated with bromhexine, methylprednisolone, doxofylline, budesonide, terbutaline, ipratropium bromide, and polyene phosphatidylcholine due to bronchial asthma, acute onset of chronic obstructive pulmonary disease, and abnormal liver function. His condition was improved. On day 4 of treatment, methylprednisolone was stopped and saxagliptin was given orally 5 mg once daily due to obvious elevated blood glucose after meals. The patient showed no abnormalities after taking saxagliptin for the first time. But about 5 minutes after taking the drug for the second time, anaphylactic shock symptoms such as loss of consciousness, lockjaw, and cyanosis appeared. The pulse oxygen saturation was 0.54. It was considered to be caused by saxagliptin. Epinephrine 0.5 mg was immediately administered subcutaneously, but the patient′s oxygen saturation decreased progressively. The patient′s condition became progressively worse, rescues such as cardiopulmonary resuscitation, endotracheal intubation via balloon assisted ventilation, epinephrine, atropine, and glucocorticoid were performed for about 1 hour, but it was ineffective. About 4 hours later, the patient still had no spontaneous breathing and was declared clinically dead.

A 60-year-old male patient was treated with bromhexine, methylprednisolone, doxofylline, budesonide, terbutaline, ipratropium bromide, and polyene phosphatidylcholine due to bronchial asthma, acute onset of chronic obstructive pulmonary disease, and abnormal liver function. His condition was improved. On day 4 of treatment, methylprednisolone was stopped and saxagliptin was given orally 5 mg once daily due to obvious elevated blood glucose after meals. The patient showed no abnormalities after taking saxagliptin for the first time. But about 5 minutes after taking the drug for the second time, anaphylactic shock symptoms such as loss of consciousness, lockjaw, and cyanosis appeared. The pulse oxygen saturation was 0.54. It was considered to be caused by saxagliptin. Epinephrine 0.5 mg was immediately administered subcutaneously, but the patient′s oxygen saturation decreased progressively. The patient′s condition became progressively worse, rescues such as cardiopulmonary resuscitation, endotracheal intubation via balloon assisted ventilation, epinephrine, atropine, and glucocorticoid were performed for about 1 hour, but it was ineffective. About 4 hours later, the patient still had no spontaneous breathing and was declared clinically dead.