PSA: sneezing and anaphylaxis

I’ve seen this twice in the past few months in my outpatient cardiology job from patients receiving IV contrast and developing an allergic reaction- I wasn’t really aware of the association between sneezing and severe allergic reaction which may progress to anaphylaxis but will now forever be keeping it in mind

“Sneezing is a common, early sign of an allergic reaction that can rapidly escalate into anaphylaxis, a severe and life-threatening condition. While sneezing alone is mild, when combined with symptoms like itching, hives, swelling, or breathing difficulties, it is a warning sign of a severe reaction requiring immediate epinephrine”

First patient ended up intubated after developing anaphylactic shock (no previously known allergy) but expected to make full recovery

Second patient had known contrast allergy so was premeditated with prednisone/Benadryl but did develop some hives and throat itching

Both cases the patients first symptom was sneezing

It makes sense given sneezing is part of the histamine response to an allergen but wanted to share!