Acute allergic reaction caused by hyaluronidase used in the pain management: a case report and literature review: A case report

Song, Yoon Kang; Kim, Yeon Dong; Kim, Jae Hong

Case Report

Spinal Pain

Anesthesia and Pain Medicine 2014;9(3):174-178.
Published online July 31, 2014.

Acute allergic reaction caused by hyaluronidase used in the pain management: a case report and literature review: A case report

Yoon Kang Song, Yeon Dong Kim, Jae Hong Kim

Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine, Iksan, Korea. kydpain@hanmail.net

Received: 3 February 2014 • Revised: 24 March 2014

Abstract

Hyaluronidase is a protein enzyme extracted from goat or ovine testis. It breaks down hyaluronic acid in connective tissues, thereby reducing swelling and edema and increasing drug penetration into tissues after injection. Because of these properties, it is being increasingly used in the field of pain management. The most frequently reported hyaluronidase-induced complications are allergic reactions, and are usually reported in cases involving eye surgery. However, there are only a few cases of allergic reactions reported in the field of pain management. Here, we report a case involving a 52-year-old patient diagnosed with an allergic reaction after receiving epidural administration of hyaluronidase. A literature review and comparison of our case with similar cases suggested the potential mechanisms underlying these allergic reactions and emphasized the importance of considering the possibility of these reactions in patients receiving hyaluronidase during the course of pain management procedures.

Key Words: Allergic reaction, Epidural injection, Hyaluronidase