[A case undergoing repeated anaphylactic shock after systemic administration of vinorelbine]

We here describe a 49-year-old man who suffered repeated anaphylactic shock after systemic chemotherapy with vinorelbine for stage IV left lung adenocarcinoma (S1+2). He was treated using a combination of cisplatin and weekly irinotecan (CPT-11) as the first line; however, the regimen was changed to a combination of vinorelbine (VNR) and gemcitabine (GEM) because of his progressive disease. He was admitted to our hospital for examination of the unknown cause of hypotension and loss of consciousness. The second shock occurred after eating pistachios, and the third one at cancerous pain. After pain control, the shock no longer occurred. Anaphylactic shock may show two peaks and late symptoms. In patients with a history of anaphylactic shock, we should pay attention to foods, drugs, and various stresses which might cause anaphylaxis.