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A 66-year-old man developed anaphylaxis after receiving hydrocortisone. He had an exacerbation of asthma and respiratory infection. He developed urinary incontinence, generalised erythematous rash, dyspnoea, rhinoconjunctivitis and wheezing immediately after receiving IV hydrocortisone [dose not stated]. He was treated with adrenaline, clemastine, salbutamol and ipratropium. He was prescribed topical corticosteroids, montelukast, azithromycin, an adrenaline kit and he was advised to avoid any systemic corticosteroid. Basophil activation test (BAT) was positive with hydrocortisone and methylprednisolone suggesting IgE- mediated reaction [outcome not stated].