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 complete infusion. 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 - Belgium 803285246 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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