Acute asthma attack caused by ophthalmic application of antiallergic agents.
BACKGROUND
To investigate the induction of acute asthmatic attacks caused by several kinds of antiallergic eyedrops for the treatment of allergic conjunctival diseases in a patient with bronchial asthma and aspirin sensitivity.


METHODS
A 42-year-old man with a 10-year history of bronchial asthma and with aspirin sensitivity, who had been given disodium cromoglycate (DSCG) to be applied topically, developed asthma after applying DSCG drops.


METHODS
After the instillation of DSCG, tranilast, ibudilast, and ketotifen, the peak expiratory flow rate (PEFR) decreased in this patient and asthmatic signs developed. However, there was no decrease in the PEFR after challenge with pemirolast, levocabastine, or fluorometholone (0.1%) eyedrops, or saline as control.


CONCLUSIONS
This case suggests that mast-cell-stabilizer eyedrops might induce an asthma attack in patients with a history of asthma and aspirin or nonsteroidal antiinflammatory drug allergy. Mast-cell-stabilizing eyedrops should be prescribed for such patients with special precautions unless the patient is known to tolerate mast cell stabilizers without difficulty.
Uchio
Eiichi
E
Department of Ophthalmology, Yokohama City University Medical Center, Yokohama 232-0024, Japan. euchio@urahp.yokohama-cu.ac.jp.
Kadonosono
Kazuaki
K
D000287:Administration, Topical; D000328:Adult; D018926:Anti-Allergic Agents / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects; D001249:Asthma / Q000139:chemically induced* / Q000150:complications; D003233:Conjunctivitis, Allergic / Q000188:drug therapy*; D004205:Cromolyn Sodium / Q000009:adverse effects; D006801:Humans; D008297:Male; D009883:Ophthalmic Solutions / Q000009:adverse effects
D018926:Anti-Allergic Agents; D009883:Ophthalmic Solutions; D004205:Cromolyn Sodium; D001241:Aspirin