A 74-year-old soybean allergy woman with anaphylaxis after propofol injection

Methods A previously healthy 74-year-old woman visited our hospital to undergo esophagogastroduodenoscopy for a checkup. She had an allergy to soybean. Approximately 1 min following administration of intravenous propofol, stridor was heard and oxygen saturation fell to 56% on pulse oximetry. We decided to stop the exam, and tried to remove the endoscope. But, the endoscope has stuck in her throat and it was not pulled out. We removed the endoscope by compulsion. After 10 seconds endoscope removal, severe wheezing was heard and her oxygen saturation fell to 56%. The larynx was observed using a laryngoscope for endotracheal intubation. At that time marked swelling and severe edema of the epiglottis and heavy mucoid secretion in the epiglottis extending to the arytenoids cartilage was detected. Immediately 1mg epinephrine was administered subcutaneously, together with 150 mg intravenous methylprednisolone was infused. Because the patient was not improved in symptom after 1 minute, 1mg epinephrine was administered intravenously. After 1minute, her oxygen saturation recovered to 98% and the wheezing was subsided.