Catamenial anaphylaxis in three patients

Catamenial anaphylaxis, also called cyclical anaphylaxis, describes recurrent episodes of multi-system allergic reactions occurring at the time of menstruation. This case reports demonstrates the management of three women with catamenial anaphylaxis. The first patient is a 38 years old woman who presented with symptoms consistent with anaphylaxis in relation to her menstrual cycle. Her symptoms were controlled with cetirizine at a dose of 20 mg daily. The second patient is 33 years old with similar symptoms coinciding with her menses. We were able to control her symptoms with leuprolide (Lupron), a luteinizing hormone releasing hormone (LHRH) agonist. The third was a 29 years old woman with catamenial anaphylaxis who was successfully treated with Depo-Provera (medroxyprogesterone). Catamenial anaphylaxis is a rare yet an important presentation to the Allergist/Clinical immunologist. The management of the patients we present here represents a spectrum of the different therapies tried in the medical literature. Here, we report the first successful use of medroxyprogesterone for such rare, yet critical medical condition.