[Acute severe dyspnea as a side effect of drugs. Report from the CHDM (Comprehensive Hospital Drug Monitoring)].

This "syndrome" has been observed in 4 of 23,935 in-patients registered in the years 1974-1987 in the Comprehensive Hospital Drug Monitoring (Bern/St. Gallen), with 6 reactions. Signs of an attack of bronchial asthma, laryngeal or pulmonary edema or a (heart-)circulatory event were not observed. Each patient was cyanotic and 3 had the feeling of impending death. The eliciting drugs were penicillin-G (twice) and cefazolin (once), given i.v.; iron dextran i.m. (once); pitressin tannate i.m. (once) and dicobalt edetate (Kelocyanor) i.v.(once). In each case the reaction started during or shortly after injection of the drug; the duration of the reaction in 5 of these events was 20-80 minutes. The pathomechanism could be a special form of anaphylactic reaction with acute pulmonary hypertension, comparable to IgE-induced anaphylaxis in the rabbit or aggregate anaphylaxis in the monkey or the dog. Further observations are needed for more detailed study.