Reactions 1680, p152 - 2 Dec 2017
Anaphylaxis: case report
A 62-year-old man developed anaphylaxis during treatment
with gelatin [Gelofusine].
The man was undergoing hip surgery. He received a gelatin-
containing plasma expander [route not stated] during general
anaesthesia. He also received chlorhexidine for
decontamination. Fifteen minutes later, he showed
anaphylaxis. He had received propofol, sufentanil, lidocaine,
dexamethasone and rocuronium bromide 2.25 hours before,
along with cefazolin, 1.75 hours before the occurrence of
anaphylaxis. Gelatin infusion 500mL was stopped after near
The man was treated with epinephrine, norepinephrine,
promethazine, sodium chloride [saline] and hydrocortisone.
His serum tryptase showed transient elevation. At 1.5 hours
after anaphylaxis, his specific IgE for gelatin was negative.
However, a repeat sampling after the event showed positive
results on day 16 and day 96. On day 18, he underwent
another intervention under general anaesthesia without
gelatin-containing plasma expanders, which showed no effect.
An allergy work-up was conducted four weeks later. He
developed wheals of 3
5mm diameters following skin prick
tests with gelatin-containing plasma expander. His skin prick
test for chlorhexidine, cefazolin and latex were negative. Based
on the results of the allergy work-up, gelatin induced
anaphylaxis was confirmed. The initial false negative result of
specific IgE to gelatin was thought to be due to the competition
between intravascular high-molecular-weight gelatin infusion
and the gelatin ImmunoCAP assay [outcome not stated].
Author comment: "The allergy work-up showed that
anaphylaxis was due to gelatin allergy."
Breynaert C, et al. Initial false-negative specific IgE to gelatin in gelatin-induced
anaphylaxis. Journal of Investigational Allergology and Clinical Immunology 27:
333-335, No. 5, 2017. Available from: URL: http://doi.org/10.18176/jiaci.0187 -
Reactions 2 Dec 2017 No. 16800114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved