Biphasic anaphylaxis reaction in adult female: how to approach?
DOI:
https://doi.org/10.18203/2349-3933.ijam20242316Keywords:
Anaphylactic reaction, Biphasic anaphylaxis, AllergyAbstract
Anaphylaxis is a severe allergic reaction, usually occurring one to two hours after exposure to an allergen, that can lead to death. Estimated lifetime prevalence of anaphylaxis is 1.6-5.1%, with global incidence between 50 to 112 episodes per 100.000 persons per year. Biphasic anaphylaxis is a form of recurrent anaphylaxis occurring between 1 to 72 hours after resolution of initial anaphylactic episode. Our case presents an 18-year-old female patient admitted to the emergency department (ED) with chief complaint of shortness of breath and swollen eyes after contact with caterpillar while gardening. General physical examination presented tachycardia, tachypnea, angioedema, urticaria. Localized lung examination presented bilateral wheezing. Patient fulfilled NIAID/FAAN criteria. Patient was administered 0.3 mg epinephrine intramuscular, diphenhydramine injection 10 mg, dexamethasone injection 5 mg, and observed in ED for 1 hour. Patient was then transferred to intensive care unit (ICU) and was in resolution. However, patient presented again with initial symptoms of dyspnea, swollen eyes, and itchiness while under observation. The objective of this paper is to present a rare case of biphasic anaphylaxis and further highlight the importance of awareness to occurrence of biphasic anaphylaxis.
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