Taking a Painkiller While Training for a Marathon Triggered a Woman’s Life-Threatening Allergy

Doctors in Pennsylvania have reported a peculiar case of allergy in a 40-year-old lady, one which may unnerve informal joggers and marathon runners alike. Their affected person developed a extreme allergic response after taking a nonsteroidal anti-inflammatory drug, or NSAID, throughout a coaching run for a marathon. Doctors imagine that the train and NSAID mixed precipitated the allergy. The lady recovered with out lasting damage and hasn’t skilled any comparable episodes whereas exercising since.

The lady had lengthy been an avid runner. And like many long-distance runners, she had determined to take a NSAID previous to her fateful run, one thing she had carried out earlier than with no challenge. By mile 4, nevertheless, she started to expertise itching and puffy eyes. By mile six, she was vomiting and having bother respiration, together with hives and lightheadedness—indicators of full-blown anaphylaxis, a extreme, life-threatening allergic response. At that time, she referred to as for her husband to take her to the emergency room. Thankfully, the anaphylaxis was managed efficiently there, and she or he was discharged quickly after.

Allergies to NSAIDs (an immune overreaction that entails IgE antibodies) and anaphylaxis induced by train are each uncommon however well-known occurrences, in keeping with Sebastian Sylvestre, a main care doctor in Pennsylvania who handled the lady. But close to as he and his colleagues might inform, there have been only a few stories within the medical literature the place an episode of exercise-induced anaphylaxis appears to have been precipitated or triggered by NSAID use. The lady’s case was unusual sufficient for the docs to present the incident on the annual assembly of the American College of Allergy, Asthma and Immunology (ACAAI) this week.

Unusual because the case could be, Sylvestre and his co-authors do have some theories as to the way it occurred. As anybody who’s ever skilled hay fever is aware of, histamine performs a serious function in inflicting allergic reactions and anaphylaxis. And it’s possible that each the train and the lady’s NSAID use set off a powder keg of histamine in her physique.

“Exercise can promote histamine release through release from basophils, a type of cell normally found in the body. NSAIDs can promote histamine release both through direct stimulation of other cells normally found in the body that also contain histamine (specifically ‘mast cells’) as well as through an allergic (IgE-mediated) process,” Sylvestre defined in an e mail to Gizmodo. “It is possible that a combination of these processes is what led to the development of anaphylaxis in this patient.”

Though it’s attainable that the lady might safely use NSAIDs outdoors of train, Sylvestre notes {that a} mainstay of allergy therapy is to advise avoidance of a attainable set off. And the lady does strictly keep away from them now. She additionally carries an epinephrine pen together with her always, simply in case. But she’s been capable of resume train with none issues.

NSAIDs aren’t risk-free, and there are different explanation why runners ought to limit their use of them earlier than a run, since they’ll contribute to dehydration and gastrointestinal issues. So whereas this significantly cursed flip of occasions isn’t more likely to occur to most of us, Sylvestre does suppose folks ought to pay attention to the danger, particularly in the event that they’ve ever had previous episodes of anaphylaxis.

“The main takeaway from this case report is that, though rare, it is possible that a combination of NSAID use and exercise can manifest in the onset of symptoms consistent with an allergic reaction,” he mentioned. “In individuals with a reaction history supportive of an allergy/anaphylaxis, it is important to subsequently always work out with a ‘buddy’ to ensure that if signs/symptoms of anaphylaxis emerge, administration of epinephrine and/or presentation to healthcare is not delayed.”