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Background: IgG 4 related disease (IgG4RD) is a newly described multisystem fibroinflammatory disorder. There is a paucity of literature describing the Australian experience of this rare condition.Aims: To characterise the Royal Adelaide Hospital IgG4RD cohort with biopsy-proven disease.Methods: A search of the Frome Road SA Pathology database was performed for all tissue biopsies containing the phrase 'IgG 4 positive'. Case notes were reviewed for clinical details, laboratory and radiology results. Histological features according to the Boston Criteria were used. Patients with available case notes, highly suggestive or probable histology and clinical features to suggest IgG4RD were included.

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Sumatriptan is an effective and well-tolerated medication used for the acute relief of migraines. It blocks nociceptive neurotransmission by binding onto 5-HT1b and 5-HT1d-like serotonin receptors and vasoconstricting cerebral and dural blood vessels. 1 It contains a sulfonamide chemical group and hence is considered a sulfa drug. We report a rare report of skin test-proven sumatriptan anaphylaxis in an 18year-old woman. CaseThe patient presented to the hospital after developing blurry vision, presyncope, a tight throat, lip angioedema, thorax rash, and feeling nauseous 15 minutes after taking a 50 mg sumatriptan succinate oral tablet for a mild migraine. This was the second tablet of sumatriptan in a course for a migraine with the first dose taken the day before. She denied taking any other medications, and her last food intake was more than 10 hours before.She is atopic with a background history of allergic asthma. She is now well-controlled on pro re nata use of inhaled salbutamol, taken mainly on exertion. The patient also has mild intermittent allergic rhinitis, mild eczema, and dysmenorrhea managed with an oral contraceptive pill. She is on no other regular medications and is a nonsmoker.

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