Intest Res.  2015 Jan;13(1):90-94. 10.5217/ir.2015.13.1.90.

Anaphylactic Shock Caused by Ingestion of Polyethylene Glycol

Affiliations
  • 1Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine, Seoul, Korea. drcha@khu.ac.kr

Abstract

Colonoscopy is the current standard method for evaluation of the colon. The diagnostic accuracy and therapeutic safety of colonoscopy depend on the quality of colonic cleansing and preparation. Generally, all these preparations have been demonstrated to be safe for use in healthy individuals without significant comorbid conditions. Based on safety and efficacy concerns, polyethylene glycol (PEG) is most commonly utilized as a bowel preparation solution for colonoscopy. Adverse events in patients receiving PEG are mostly clinically non-significant. However, fatal adverse events rarely have been shown to occur in the few individuals who experience vomiting or aspiration. Anaphylactic shock associated with ingestion of PEG electrolyte solution is an extremely rare fatal complication, and reported mainly in Western countries. Here, we report the first case of anaphylactic shock following the ingestion of PEG solution in Korea.

Keyword

Polyethylene glycols; Anaphylaxis; Adverse effects; Colonoscopy; Shock

MeSH Terms

Anaphylaxis*
Colon
Colonoscopy
Eating*
Humans
Korea
Polyethylene Glycols*
Shock
Vomiting
Polyethylene Glycols

Cited by  1 articles

Anaphylaxis due to polyethylene glycol: A case report
Tae-Se Kim, Dong-Chull Choi, Byung-Jae Lee
Allergy Asthma Respir Dis. 2018;6(5):274-276.    doi: 10.4168/aard.2018.6.5.274.


Reference

1. Lee BI, Hong SP, Kim SE, et al. Korean guidelines for colorectal cancer screening and polyp detection. Intest Res. 2012; 10:67–88.
Article
2. Wexner SD, Beck DE, Baron TH, et al. A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Gastrointest Endosc. 2006; 63:894–909. PMID: 16733101.
Article
3. Markowitz GS, Stokes MB, Radhakrishnan J, D'Agati VD. Acute phosphate nephropathy following oral sodium phosphate bowel purgative: an underrecognized cause of chronic renal failure. J Am Soc Nephrol. 2005; 16:3389–3396. PMID: 16192415.
Article
4. Rostom A, Jolicoeur E, Dubé C, et al. A randomized prospective trial comparing different regimens of oral sodium phosphate and polyethylene glycol-based lavage solution in the preparation of patients for colonoscopy. Gastrointest Endosc. 2006; 64:544–552. PMID: 16996347.
Article
5. Raymond PL. Mallory-Weiss tear associated with polyethylene glycol electrolyte lavage solution. Gastrointest Endosc. 1991; 37:410–411. PMID: 2071009.
Article
6. Kim CH, Park JH, Kim MW, et al. A case of Boerhaave's syndrome after bowel preparation with polyethylene glycol. Korean J Gastrointest Endosc. 2005; 31:315–319.
7. de Graaf P, Slagt C, de Graaf JL, Loffeld RJ. Fatal aspiration of polyethylene glycol solution. Neth J Med. 2006; 64:196–198. PMID: 16788218.
8. Assal C, Watson PY. Angioedema as a hypersensitivity reaction to polyethylene glycol oral electrolyte solution. Gastrointest Endosc. 2006; 64:294–295. PMID: 16860094.
Article
9. Stollman N, Manten HD. Angioedema from oral polyethylene glycol electrolyte lavage solution. Gastrointest Endosc. 1996; 44:209–210. PMID: 8858338.
Article
10. Brullet E, Moron A, Calvet X, Frias C, Sola J. Urticarial reaction to oral polyethylene glycol electrolyte lavage solution. Gastrointest Endosc. 1992; 38:400–401. PMID: 1607106.
Article
11. Lee JS, Chae HS, Chung WC, et al. Urticaria reaction by oral polyethylene glycol ingestion. Korean J Gastrointest Endosc. 2002; 24:299–301.
12. Schuman E, Balsam PE. Probable anaphylactic reaction to polyethylene glycol electrolyte lavage solution. Gastrointest Endosc. 1991; 37:411. PMID: 2071010.
Article
13. Shah S, Prematta T, Adkinson NF, Ishmael FT. Hypersensitivity to polyethylene glycols. J Clin Pharmacol. 2013; 53:352–355. PMID: 23444288.
Article
14. Savitz JA, Durning SJ. A rare case of anaphylaxis to bowel prep: a case report and review of the literature. Mil Med. 2011; 176:944–945. PMID: 21882787.
Article
15. Davis GR, Santa Ana CA, Morawski SG, Fordtran JS. Development of a lavage solution associated with minimal water and electrolyte absorption or secretion. Gastroenterology. 1980; 78:991–995. PMID: 7380204.
Article
16. Hyun JJ, Jeen YT, Park SH, et al. Comparison of 4 L of PEG versus combination of 2 L of PEG and 45 mL of sodium phosphate for colonoscopy colon cleansing: a prospective randomized trial. Korean J Gastrointest Endosc. 2005; 31:368–373.
17. Yamasuji Y, Higashi Y, Sakanoue M, et al. A case of anaphylaxis caused by polyethylene glycol analogues. Contact Dermatitis. 2013; 69:183–185. PMID: 23948038.
Article
18. Sampson HA, Muñoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report--Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol. 2006; 117:391–397. PMID: 16461139.
Article
19. Worm M, Babina M, Hompes S. Causes and risk factors for anaphylaxis. J Dtsch Dermatol Ges. 2013; 11:44–50. PMID: 23181736.
Article
20. Kemp SF, Lockey RF, Simons FE. Epinephrine: the drug of choice for anaphylaxis. A statement of the World Allergy Organization. Allergy. 2008; 63:1061–1070. PMID: 18691308.
Article
21. Brown SG, Blackman KE, Stenlake V, Heddle RJ. Insect sting anaphylaxis; prospective evaluation of treatment with intravenous adrenaline and volume resuscitation. Emerg Med J. 2004; 21:149–154. PMID: 14988337.
Article
22. Chung HL. Clinical significance of serum IgE. Korean J Pediatr. 2007; 50:416–421.
Article
23. Ito K, Urisu A. Diagnosis of food allergy based on oral food challenge test. Allergol Int. 2009; 58:467–474. PMID: 19847093.
Article
24. Sohy C, Vandenplas O, Sibille Y. Usefulness of oral macrogol challenge in anaphylaxis after intra-articular injection of corticosteroid preparation. Allergy. 2008; 63:478–479. PMID: 18315736.
Article
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