Repeated anaphylactic reaction after walking following an intraarticular injection of diclofenac etalhyaluronate sodium during a 3‐day period

Abstract

Background There has been no English report of repeated anaphylactic reaction after exercise‐induced anaphylaxis due to a single intraarticular injection of diclofenac etalhyaluronate sodium. Case Presentation A 60‐year‐old woman felt dyspnea, generalized itching, and urticaria following hypotension a few minutes after receiving an intraarticular injection of diclofenac etalhyaluronate sodium for the first time. She immediately received intramuscular adrenaline administration and her symptoms subsided. However, she received intermittent injections of adrenaline three times for repeated anaphylactic reactions after walking over a 3‐day period, in addition to complication with Kounis syndrome. She was discharged on foot on day 9 without sequelae. Conclusion Physicians should have patients who receive intraarticular injection of diclofenac etalhyaluronate sodium walk for a short period and evaluate their status.

Keywords

• anaphylaxis
• diclofenac etalhyaluronate sodium
• intraarticular injection
• Kounis syndrome