# Polyethylene Glycol (PEG)-Induced Anaphylaxis: A Cautionary Case for the Gastroenterologist in the COVID Era

## TL;DR

A 37-year-old woman experienced severe anaphylaxis after ingesting polyethylene glycol (PEG), highlighting its potential to cause allergic reactions.

## Contribution

This case highlights PEG's immunogenic potential and raises awareness for gastroenterologists in the context of increased PEG use during the COVID era.

## Key findings

- The patient developed anaphylaxis within 15 minutes of PEG ingestion.
- An acute tryptase rise and skin testing confirmed PEG allergy.
- This case underscores the need for caution with PEG-containing products.

## Abstract

Polyethylene glycol (PEG) has widespread use and, while initially thought to be inert, has proven to be immunogenic. We discuss the case of a 37-year-old female patient who was admitted to the intensive care unit (ICU) after sustaining a cardiac arrest in the community. Fifteen minutes after ingestion of PEG, she developed hand swelling, which over minutes progressed to difficulty with breathing and swallowing. The Allergy service was consulted. Anaphylaxis was suspected by the presentation and confirmed after detailed exposure and ingestion history, along with an acute tryptase rise. Allergy to PEG was confirmed by skin testing in the outpatient allergy clinic after the patient was discharged from the hospital.