Reactions 1704, p210 - 2 Jun 2018 Anisocoria: case report A 5-year-old boy developed anisocoria during treatment with ipratropium-bromide [ipratropium; dose not stated]. The boy had obstructive sleep apnea, trisomy 21, paroxysmal tonic up-gaze and moderate persistent asthma. He presented to the paediatrician with fever, increased work of breathing, cough and congestion. A diagnosis of pneumonia was made. He started receiving treatment with prednisone, salbutamol [albuterol], amoxicillin, nebulisers of ipratropium- bromide twice a day and nasal sprays of ipratropium-bromide two times a day. One week after the treatment, he developed a fixed and dilated left pupil. He was admitted to the emergency department. He was diagnosed with anisocoria without ophthalmoplegia. His right pupil 3mm to 2mm, and left pupil 5.5mm to 5mm. For sedated MRI, he was hospitalised for two days, and his results were normal. On the admission, the boy’s treatment with ipratropium- bromide was discontinued. A complete resolution of anisocoria was occurred, 48 hours after the discontinuation of ipratropium-bromide. He was discharged from the hospital. Author comment: "Anisocoria is a documented side effect of ipratropium.""Ipratropium is a muscarinic cholinergic receptor antagonist that inhibits the parasympathetic system responsible for pupillary constriction." Harer K, et al. Eye-opening etiologies. Hospital Pediatrics 8: 300-301, No. 5, May 2018. Available from: URL: http://doi.org/10.1542/hpeds.2017-0204 - USA 803323575 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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