[A case of anaphylactic reaction after pleurodesis with OK-432].

A 60-year-old woman had received adjuvant chemotherapy after abdominal hysterectomy for clear cell carcinoma of the endometrium. She had no history of allergy. She was admitted to our hospital because of massive pleural effusion. She underwent drainage of left-side malignant pleural effusion followed by chemical pleurodesis with OK-432 via a chest tube. Ten minutes after administration of OK-432 to the thoracic cavity, she complained of dyspnea and showed general flushing. Since the clinical course suggested drug-induced anaphylactic reaction, she was immediately treated with an adrenaline subcutaneous injection and methylprednisolone sodium succinate intravenous injection. However, the respiratory insufficiency progressively deteriorated and mechanical ventilation was needed for the next 3 days. This is the first published case of anaphylactic reaction to OK-432 pleurodesis. In Japan, OK-432 is a key drug used for pleurodesis and we should consider possible serious adverse reactions include anaphylactic reaction.