title: A case of levofloxacin-induced anaphylaxis with elevated serum tryptase levels.
abstract: Levofloxacin, a fluoroquinolone and L-isomer of the racemate ofloxacin, has been approved for the treatment of acute and chronic bacterial infections. Gastrointestinal complaints are the most frequently reported adverse drug reactions to fluoroquinolones. Other adverse events include headache, dizziness, increased liver enzyme levels, photosensitivity, tachycardia, QT prolongation, and eruptions. Anaphylaxis has been documented as a rare adverse drug reaction to levofloxacin; however, diagnostic tests are needed to evaluate whether these reactions are the result of levofloxacin treatment. While the results of skin tests are considered unreliable due to false-positive responses, the oral provocation test is currently considered to be the most reliable test. Tryptase, a neutral protease, is the dominant protein component of secretory granules in human mast cells, and an increased serum concentration of tryptase is a highly sensitive indicator of anaphylaxis. Herein, we report a case of levofloxacin-induced anaphylaxis in which the patient exhibited elevated serum tryptase levels and a positive oral levofloxacin challenge test result. As anaphylaxis is potentially life-threatening, the administration of fluoroquinolones to patients who have experienced a prior reaction to this type of agent should be avoided.
authors: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors: Ji-Ho
authors: JH
authors: Lee
authors: Won Yeon
authors: WY
authors: Lee
authors: Suk Joong
authors: SJ
authors: Yong
authors: Kye Chul
authors: KC
authors: Shin
authors: Myoung Kyu
authors: MK
authors: Lee
authors: Chong Whan
authors: CW
authors: Kim
authors: Sang-Ha
authors: SH
authors: Kim
keywords: Anaphylaxis; drug hypersensitivity; fluoroquinolones; levofloxacin; provocation tests; tryptase