Anaphylactic shock

During CNY, my sister's family spent time at her in-laws place in Penang island. They invited mum to join them and I was glad that mum decided to go. However, when she was there, she had an allergic reaction: rashes, redness and itches over her body. She suspected it was the bar of soap. Mum had a history of contact dermatitis, the most serious were her fingers turning nearly black.

Sister brought her to a 24-hour clinic for treatment. Was given antihistamine and calomine lotion. The next morning, my sister was helping to apply the lotion on mum when she suddenly collapsed on her bed, with hands pointing up (elbows on bed) and shaking. Mum didn't respond to sister's calling until a minute later when this seizure-like moment was over. Scary.

After some discussion, my sister brought her back to the clinic. They said although it's possible that this is a side effect of antihistamine, it's rare and even more so for the one they prescribed i.e. chlorphenamine. However, in case it mattered, they prescribed steroid cream (to replace the antihistamine). They also said that we should bring her to a hospital to scan mum's brain for possible advent of stroke. It should be done within few hours of the seizure-like moment.

My sister's family were going back to Butterworth and so brought mum to Bagan Specialist Centre. They said it was unlikely due to stroke but nevertheless ordered MRI for the brain. Also ordered were X-ray of the lungs (mum had difficulty breathing) and the usual blood work. We also agreed with their strong recommendation of admitting mum to HDU (high-dependent unit) for two nights so that she can be closely watched over 1-to-1 since she had very low blood pressure (80/40) and bad allergic reactions on a whole. However, the good news was that hey said it was unlikely due to stroke.

Mum recovered faster than expected: she was shifted to normal ward late afternoon the next day and discharged a day thereafter. Brain MRI and chest X-ray were clear. Relevant tests on kidney were back to normal. CRP dropped from a high score but still need to continue taking antibiotics. The suspicion is that there was underlying infection that heightened the allergy and using the soap triggered it.

Diagnosis: anaphylactic shock. When I accompany mum to the follow-up appointment, I would ask doctor for recommended allergy test. She did a skin patch test 9 years ago and two allergens were highlighted: balsam of Peru (25%) and perfume (8%).