A case of midazolam anaphylaxis

Abstract

Midazolam is a type of anesthetic agent frequently used for conscious sedation during a variety of medical procedures. Anaphylactic reactions to midazolam are rarely reported. However, we observed a case of midazolam hypersensitivity in which emergency measures were required to ensure patient recovery after administration of midazolam as a sedative. The occurrence of the anaphylactic reaction to midazolam was confirmed by elevated serum tryptase levels. The current case report presents a discussion of our findings.

Keywords: Anaphylaxis; Midazolam; Tryptases.

Fig. 1

Electrocardiography. (A) A normal sinus rhythm was confirmed prior to esophagogastroduodenoscopy. (B) A sinus tachycardia pattern was observed during anaphylactic shock.

Fig. 2

Chest X-ray image finding and chest computed tomography (CT) findings. (A) No abnormal findings were noted on the chest X-ray anteroposterior image taken during the event. (B) Pleural effusion and mediastinal lymphadenopathy in both lungs were not observed in the mediastinal setting of chest CT. (C) No active lesion was observed in either lung in the lung parenchymal setting of chest CT.

Fig. 3

Echocardiography findings. Nonspecific findings with normal wall motion were detected, excepting depletion of the right ventricular volume.