A CASE OF VOCAL CORD DYSFUNCTION, WHO USED ADRENALIN AUTOINJECTOR (EPIPEN<sup>®</sup>) FREQUENTLY AFTER BEING DIAGNOSED AS ANAPHYLAXIS

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  • Teranishi Hiromi
    Department of Pediatrics, Saitama Medical University Hospital
  • Koga Takeshi
    Department of Pediatrics, Saitama Medical University Hospital Allergy center, Saitama Medical University Hospital
  • Ueda Yutaka
    Department of Pediatrics, Saitama Medical University Hospital Allergy center, Saitama Medical University Hospital
  • Shimizu Takahiro
    Department of Pediatrics, Saitama Medical University Hospital Allergy center, Saitama Medical University Hospital
  • Okada Keisuke
    Department of Pediatrics, Saitama Medical University Hospital Allergy center, Saitama Medical University Hospital
  • Ogawa Shunichi
    Department of Pediatrics, Saitama Medical University Hospital Allergy center, Saitama Medical University Hospital
  • Morita Eiji
    Department of Pediatrics, Saitama Medical University Hospital Allergy center, Saitama Medical University Hospital
  • Itazawa Toshiko
    Department of Pediatrics, Saitama Medical University Hospital Allergy center, Saitama Medical University Hospital
  • Tokuyama Kenichi
    Department of Pediatrics, Saitama Medical University Hospital Allergy center, Saitama Medical University Hospital

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Other Title
  • アナフィラキシーと診断され，アドレナリン自己注射薬（エピペン<sup>®</sup>）を頻回使用していたVocal Cord Dysfunctionの1例
  • アナフィラキシーと診断され,アドレナリン自己注射薬(エピペン)を頻回使用していたVocal Cord Dysfunctionの1例
  • アナフィラキシー ト シンダン サレ,アドレナリン ジコ チュウシャヤク(エピペン)オ ヒンカイ シヨウ シテ イタ Vocal Cord Dysfunction ノ 1レイ

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<p>We experienced a case of vocal cord dysfunction (VCD) in a child to whom an adrenaline autoinjector (Epipen®) had been prescribed and frequently used following a diagnosis of exercise-induced anaphylaxis. An exercise test was performed to investigate her frequent episodes of anaphylaxis-like symptoms. A few minutes after starting the test, signs of dyspnea, such as throat tightness and stridor, appeared, although hypoxia was not present and her respiratory sounds were normal. Medications were not effective for treating her respiratory symptoms. Laryngoscopy performed at the test revealed bizarre vocal cord movement, which was diagnosed as VCD. The symptoms gradually diminished after the initiation of biofeedback therapy, including pursed lips breathing and abdominal breathing. Thereafter, she did not use an adrenaline autoinjector when symptoms appeared; instead, she would perform biofeedback therapy before using the adrenaline autoinjector. Thus, VCD should be included in the differential diagnosis of patients who show anaphylactic symptoms that are resistant to preventive therapy.</p>

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