[A case of asthma attack induced by high-dose metoclopramide]

A 39-year-old woman was admitted to our hospital for further investigation of an abnormal shadow on chest X-ray film. The chest X-ray film showed mass shadow in the right upper lung field and multiple nodular shadows in the whole lung. Histologic examination of a bronchofiberscopy biopsy specimen revealed bronchioloalveolar carcinoma. A combination chemotherapy with cis-platinum and vindesine was started. After high-dose metoclopramide (2 mg/kg) administration for the prevention of cis-platinum-induced nausea and vomiting, laryngeal obstructive sensation, stridor and expiratory dyspnea appeared. After metoclopramide was stopped, and aminophylline injected, symptoms began to disappear slowly. The above symptoms developed again following a provocation test of high-dose metoclopramide. Arterial blood gas analysis showed hypoxemia. We concluded that the asthma attack in this patient was caused by high-dose metoclopramide therapy.