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Hypertensive Anaphylaxis After Moderna COVID-19 Vaccination: A Case Report

Hypotension after exposure to an allergen is a well-known indicator of an anaphylactic reaction. However, hypertensive anaphylaxis often goes unrecognized. Increased blood pressure can present as an anaphylactic reaction, which is called hypertensive anaphylaxis. A 48-year-old woman complained of a...

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Autores principales: Furuto, Yoshitaka, Nohara, Takaya, Hamada, Hirohisa, Shibuya, Yuko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166589/
https://www.ncbi.nlm.nih.gov/pubmed/35677740
http://dx.doi.org/10.7759/cureus.25586
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author Furuto, Yoshitaka
Nohara, Takaya
Hamada, Hirohisa
Shibuya, Yuko
author_facet Furuto, Yoshitaka
Nohara, Takaya
Hamada, Hirohisa
Shibuya, Yuko
author_sort Furuto, Yoshitaka
collection PubMed
description Hypotension after exposure to an allergen is a well-known indicator of an anaphylactic reaction. However, hypertensive anaphylaxis often goes unrecognized. Increased blood pressure can present as an anaphylactic reaction, which is called hypertensive anaphylaxis. A 48-year-old woman complained of a tickle sensation in the throat and dyspnea 30 minutes after being administered the first dose of the Moderna coronavirus disease 2019 (COVID-19) vaccine. The patient had no history of hypertension, anxiety, or panic disorder. Forty-five minutes after the vaccination, stridor was noted, and the patient developed severe hypertension with a blood pressure of 197/153 mmHg. The patient also had tachycardia, cervical angioedema, and nausea, which occurred in a short period of time, indicating type I hypersensitivity reaction, that is, an anaphylactic reaction. The patient was diagnosed with Brighton classification Level 1 anaphylaxis caused by COVID-19 vaccination. For managing the patient, two intramuscular adrenaline injections, famotidine, chlorpheniramine, metoclopramide, and methylprednisolone were administered via intravenous infusion. After the administration of medications, all symptoms resolved, and the blood pressure was reduced. Other differential diagnoses for increased blood pressure after vaccination were excluded; therefore, we concluded that this phenomenon of increased blood pressure was hypertensive anaphylaxis. Not only hypotension but also the acute onset of increased blood pressure after vaccination may occur as a premonitory symptom of anaphylaxis. In hypertensive anaphylaxis, both anaphylaxis and increased blood pressure can be treated with intramuscular adrenaline injection. Clinicians should be aware of the occurrence of hypertensive anaphylaxis.
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spelling pubmed-91665892022-06-07 Hypertensive Anaphylaxis After Moderna COVID-19 Vaccination: A Case Report Furuto, Yoshitaka Nohara, Takaya Hamada, Hirohisa Shibuya, Yuko Cureus Emergency Medicine Hypotension after exposure to an allergen is a well-known indicator of an anaphylactic reaction. However, hypertensive anaphylaxis often goes unrecognized. Increased blood pressure can present as an anaphylactic reaction, which is called hypertensive anaphylaxis. A 48-year-old woman complained of a tickle sensation in the throat and dyspnea 30 minutes after being administered the first dose of the Moderna coronavirus disease 2019 (COVID-19) vaccine. The patient had no history of hypertension, anxiety, or panic disorder. Forty-five minutes after the vaccination, stridor was noted, and the patient developed severe hypertension with a blood pressure of 197/153 mmHg. The patient also had tachycardia, cervical angioedema, and nausea, which occurred in a short period of time, indicating type I hypersensitivity reaction, that is, an anaphylactic reaction. The patient was diagnosed with Brighton classification Level 1 anaphylaxis caused by COVID-19 vaccination. For managing the patient, two intramuscular adrenaline injections, famotidine, chlorpheniramine, metoclopramide, and methylprednisolone were administered via intravenous infusion. After the administration of medications, all symptoms resolved, and the blood pressure was reduced. Other differential diagnoses for increased blood pressure after vaccination were excluded; therefore, we concluded that this phenomenon of increased blood pressure was hypertensive anaphylaxis. Not only hypotension but also the acute onset of increased blood pressure after vaccination may occur as a premonitory symptom of anaphylaxis. In hypertensive anaphylaxis, both anaphylaxis and increased blood pressure can be treated with intramuscular adrenaline injection. Clinicians should be aware of the occurrence of hypertensive anaphylaxis. Cureus 2022-06-01 /pmc/articles/PMC9166589/ /pubmed/35677740 http://dx.doi.org/10.7759/cureus.25586 Text en Copyright © 2022, Furuto et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Furuto, Yoshitaka
Nohara, Takaya
Hamada, Hirohisa
Shibuya, Yuko
Hypertensive Anaphylaxis After Moderna COVID-19 Vaccination: A Case Report
title Hypertensive Anaphylaxis After Moderna COVID-19 Vaccination: A Case Report
title_full Hypertensive Anaphylaxis After Moderna COVID-19 Vaccination: A Case Report
title_fullStr Hypertensive Anaphylaxis After Moderna COVID-19 Vaccination: A Case Report
title_full_unstemmed Hypertensive Anaphylaxis After Moderna COVID-19 Vaccination: A Case Report
title_short Hypertensive Anaphylaxis After Moderna COVID-19 Vaccination: A Case Report
title_sort hypertensive anaphylaxis after moderna covid-19 vaccination: a case report
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166589/
https://www.ncbi.nlm.nih.gov/pubmed/35677740
http://dx.doi.org/10.7759/cureus.25586
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