The symptoms: The man went to an emergency department after fainting. He had felt nauseous just before the episode, which lasted about three minutes and was followed by a second fainting episode lasting about two minutes. He also had swelling around one eye.
What happened next: Because the man had fainted twice and had a history of heart disease, doctors first looked for problems affecting his brain and heart. An MRI of his brain, used to look for structural abnormalities that could explain the fainting, and an electroencephalogram (EEG), which records the brain's electrical activity, did not reveal a cause.
Meanwhile, the swelling around one of his eyes spread to both eyes and then across his face, while his blood pressure continued to fall despite treatment with intravenous fluids.
The diagnosis: Based on the man's recent use of hair dye, the itching that followed, his rapidly worsening facial swelling and his persistently low blood pressure, doctors concluded that he was experiencing anaphylaxis, a severe allergic reaction that can affect the whole body. The reaction can be life-threatening if left untreated.
Anaphylaxis is a medical emergency and can be life-threatening. (Image credit: SCIENCE PHOTO LIBRARY via Getty Images)However, the patient's blood pressure remained dangerously low, so doctors continued giving him epinephrine through an intravenous drip for about 16 hours. Over the next three days of treatment, his blood pressure stabilized and the swelling in his face gradually subsided.
What makes the case unique: Most allergic reactions to hair dye remain limited to the skin, causing itching, redness and swelling where the dye has touched it. Severe reactions affecting the whole body are uncommon, the man's doctors wrote in a report of the case.
Other dilemmasThe itching the man noticed shortly after applying the dye was likely an early, mild allergic reaction, his doctors wrote. That reaction later progressed to a much more severe one, they suggested, raising the possibility of a "biphasic" allergic reaction, an uncommon pattern seen in about 5% of patients with anaphylaxis. However, this remains only a possible explanation.
The case highlights the importance of asking about recent use of products such as hair dye when doctors evaluate patients with otherwise unexplained fainting, facial swelling or shock, the medical team concluded.
This article is for informational purposes only and is not meant to offer medical advice.
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