[Anaphylactic shock to iodinated povidone]. / Choc anaphylactique à la povidone iodée.

Anaphylaxis during anaesthesia is a rare event which is mainly related to neuromuscular blocking agents. Latex and antibiotics are less frequently incriminated. However, allergy may be triggered by other less frequent and hidden allergen. Among these, povidone is largely used in numerous therapeutics and cosmetics. We report here an exceptional case of grade 3 anaphylactic shock with iodinated povidone administered via a rectal route.

Use of both CD63 up regulation and IgE down regulation for the flow cytometric analysis of allergen induced basophil activation. Definition of an activation index.

OBJECTIVE AND DESIGN: The aim of this study was to compare the use of a late (CD63) and an early (IgE) marker of basophil activation in the flow cytometric diagnosis of beta-lactam induced allergic hypersensitivity reactions. SUBJECTS: Twelve patients who had had a clear cut betalactam induced immediate reaction and 16 controls were selected, as well as 11 patients who had had an immediate reaction to bee or wasp stings. METHODS: Leukocyte suspensions were incubated with allergen dilutions as well as 2 positive controls (anti-IgE and NFormyl- Methionyl-Leucyl-Phenylalanine (fMLP)). Basophils were labelled with an anti-IgE FITC (fluorescein isothiocyanate) and an anti-CD63 PE (phycoerythrin). Results were expressed as percentage CD63 expression and index calculated according to a specific algorithm including the two activation markers. RESULTS: Significant CD63 expression (>5 %) was observed in 3/12 cases for the beta-lactam sensitized population, in 0/16 cases for the controls and in 11/11 cases for the venom sensitized population. A significant index (determined by a ROC analysis) was observed in 11/12 beta-lactam sensitized patients and in 0/16 controls. CONCLUSION: These results show that IgE (an early activation marker) is more sensitive than CD63 (a later activation marker) in the diagnosis of beta-lactam allergy.

[Anaphylactic shock caused by fibrin glue]. / Choc anaphylactique à la colle biologique.

We observed a case of anaphylactic shock in a 68-year-old woman after a nasal intramucosal injection of fibrin glue for telangiectasies therapy. The tests showed an allergy to aprotinin contained in the glue. In the previous years, glue and aprotinin had been administered to the patient several times for nasal bleeding.

[Techniques of autologous transfusion in hip surgery: a retrospective study]. / Techniques de transfusion autologue dans la chirurgie de la hanche: étude rétrospective.

A retrospective study was carried out on 99 patients undergoing hip surgery to evaluate the efficacy of three autotransfusion techniques on sparing of homologous blood. Preoperative normovolemic hemodilution (HDN), delayed autotransfusion (ATD) and recuperation of blood lost during surgery (RSPO) were studied. Patients were divided into 5 groups: group HDN, group ATD, group ATD + HDN, group RSPO, and the control group. The hematocrit was followed intra and postoperatively within these five groups, and mean values homologous blood transfusions calculated for each group. Comparison of mean values was performed using variance analysis (p less than 0.02). The association of delayed autotransfusion and preoperative hemodilution was most effective in sparing homologous blood (0.11 +/- 0.3 unit, p less than 0.02): however these results were obtained with a substantial drop in hematocrit which fell well below the 30% minimal accepted value at the end of the operation. There was no significant difference between delayed autotransfusion (0.35 +/- 0.8 unit) and preoperative hemodilution (0.7 +/- .01 unit) in sparing homologous blood. Hematocrit values with delayed autotransfusion were greater than these obtained with preoperative hemodilution. The difference was significant at the beginning of the operation (p less than 0.001), but not significant at the end. Recuperation of blood lost during surgery was least effective in sparing homologous blood (1 +/- 1.2 unit, p less than 0.02). Because of the moderate decrease in hematocrit, there are very few contraindications to delayed autotransfusion. Recuperation of blood lost during surgery should be associated with another autotransfusion technique.(ABSTRACT TRUNCATED AT 250 WORDS)