Drug-Induced Paradoxical Vocal Fold Motion

Marlene Garcia-Neuer, Donna Marie Lynch, Kathleen Marquis, Jayme Dowdall, Mariana Castells, David Edward Sloane

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Vocal cord dysfunction, also known as paradoxical vocal fold motion (PVFM), is a disorder characterized by abnormal vocal cord adduction during inspiration. PVFM is commonly misdiagnosed as asthma because of the similarity of symptoms: cough, wheezing, chest pain, and dyspnea. We present the clinical vignette of a 36-year-old woman with juvenile rheumatoid arthritis and multiple adverse drug reactions who presented with recurrent episodes of unrecognized PVFM during skin testing for drug allergy, omalizumab treatment, and tocilizumab desensitization. Before the diagnosis of PVFM, these episodes were treated as anaphylaxis, including the administration of epinephrine. Once diagnosed and treated for PVFM, the patient did not present any further events and continued treatment for drug allergy. PVFM may be underreported in hypersensitivity reactions because of the similarity to Type 1-mediated respiratory symptoms and comorbid asthma.

Original languageEnglish (US)
Pages (from-to)90-94
Number of pages5
JournalJournal of Allergy and Clinical Immunology: In Practice
Issue number1
StatePublished - Jan 2018
Externally publishedYes


  • Adverse drug reaction
  • Anaphylaxis
  • Desensitization
  • Drug hypersensitivity
  • Paradoxical vocal fold motion
  • Vocal cord dysfunction

ASJC Scopus subject areas

  • Immunology and Allergy


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