Diclofenac induced anaphylaxis: A case report from Nepal

• Published in: Annals of medicine and surgery Vol. 80
• Main Authors: Bhattarai, Himal Bikram, Shah, Sangam, Uprety, Manish, Baniya, Santosh, Maharjan, Gyabina, Priya, Anshu, Singh, Prabesh Bikram, Subedi, Ayusha
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.08.2022; Elsevier
• Subjects: Anaphylaxis; Case Report; Diclofenac; Intravenous; Intravenous; Anaphylaxis; Diclofenac
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2022.104233

Diclofenac is considered a generally safe medication, and cause few side effects like dyspepsia, diarrhea/constipation, nausea, and vomiting, stomach bleeding, rash, urticaria, photosensitivity reactions, acute renal failure, analgesic nephropathy, bone marrow and liver diseases. Rarely, it causes anaphylactic reaction. We report a case of 40 years male who developed anaphylactic reaction after intravenous infusion with diclofenac. Both the pulmonary embolism and anaphylaxis guidelines emphasize the importance of a thorough evaluation when making a diagnosis. Mast cells secrete tryptase, a neutral protease that is specifically concentrated in the secretory granules of human mast cells (but not basophils), along with histamine, as a marker of mast cell activation. Although intravenous diclofenac sodium is a safe and often used medicine, it can cause severe and perhaps fatal anaphylactic responses. •IV diclofenac sodium can cause fatal anaphylactic responses.•It might mimic pulmonary embolism in symptoms.•Accurate and timely diagnosis of anaphylaxis and withheld of diclofenac should be done.