Acute Urticaria and Angioedema Associated with the Use of Levonorgestrel-Releasing Intrauterine System: A Case Report and Literature Review
Mehmet Genco1, Merve Genco2, Feyza Azmak Çinaz2, Semih Çinaz21Department of Obstetrics and Gynecology, Igdır State Hospital, Igdır, Türkiye2Department of Anesthesia and Reanimation, Igdır State Hospital, Igdır, Türkiye
Levonorgestrel-containing intrauterine systems (LNG-IUS) are widely used for contraception and the treatment of abnormal uterine bleeding. However, they can rarely lead to serious allergic reactions. This study aims to present a case of a 38-year-old woman who developed acute urticaria and angioedema two months after the insertion of an LNG-IUS and to synthesize similar cases reported in the literature. The patient's clinical findings, laboratory results, and treatment process were examined in detail. Allergic reactions associated with LNG-IUS and similar intrauterine devices were reviewed in the literature. Two months after LNG-IUS insertion for abnormal uterine bleeding, the patient developed widespread urticaria and facial angioedema. The urticarial lesions on the patient’s back and torso are presented in Figures 1 and 2. Despite daily treatment with 15 mg of oral methylprednisolone and 5 mg of desloratadine, her symptoms did not improve. The patient was evaluated by an allergist, and the removal of the LNG-IUS was recommended. Following the removal of the device, she responded to systemic therapy, and her symptoms completely disappeared within 15 days. Although acute urticaria and angioedema developing during LNG-IUS use are rare, clinicians should be aware of this potential adverse effect. In allergic reactions related to LNG-IUS, symptoms may resolve entirely with device removal and appropriate medical management.
Keywords: Acute urticaria, allergic reaction, angioedema, desloratadine, intrauterine device, levonorgestrel, methylprednisolone.Manuscript Language: English