ABSTRACT
Anaphylactic shock is the most severe manifestation of hypersensitivity, whether of allergic origin or not. In the operating theatre, anaphylactic shock is rare in paediatric patients and latex allergy is still the major cause of allergy. Whatever the cause and mechanism of the reaction, its treatment should be started as early as possible: a high level of suspicion is thus necessary to establish a diagnosis as early as possible. Symptomatic treatment is well codified. The results of blood sampling at the time of the reaction and of allergic tests performed a few weeks later will enable a definitive diagnosis to be made and appropriate recommendations (medical alert card) to be given to the patients and its parents.
Subject(s)
Anaphylaxis/therapy , Perioperative Care , Anaphylaxis/diagnosis , Child , Child, Preschool , Emergency Medical Tags , Female , Histamine Release , Humans , Immunoglobulin E/immunology , Infant , Intraoperative Complications/diagnosis , Intraoperative Complications/therapy , Latex Hypersensitivity/diagnosis , Latex Hypersensitivity/therapy , Male , Patient Care Management , Postoperative Complications/diagnosis , Postoperative Complications/therapy , Quaternary Ammonium Compounds/pharmacology , Skin TestsSubject(s)
Anaphylaxis/prevention & control , Latex Hypersensitivity/prevention & control , Anaphylaxis/immunology , Antibody Specificity/immunology , B-Lymphocytes/immunology , Humans , Immunoglobulin E/blood , Infant, Newborn , Latex Hypersensitivity/immunology , Meninges/immunology , Reoperation , Risk Factors , Spinal Dysraphism/immunology , Spinal Dysraphism/surgeryABSTRACT
A 72-year-old male patient was scheduled for coronary artery bypass graft surgery because of severe three-vessel disease. Induction of anaesthesia was uneventful. Following bolus infusion of tranexamic acid (Exacyl), the patient presented clinical signs consistent with anaphylactic shock. Surgery was postponed and the patient recovered without sequaelae. Allergological investigations (cutaneous tests, serum IgE concentrations, in vitro histamine-release tests) suggest that this is the first reported case of anaphylactic shock to tranexamic acid. Several weeks later, the patient underwent surgery with a similar anaesthetic regimen and the clinical course was uneventful.