Intraoperative anaphylaxis due to aprotinin after local application of fibrin sealant diagnosed by skin tests and basophil activation tests: a case report.
Anaphylaxis
Aprotinin
Basophil activation test
Fibrin sealant
Skin test
Journal
JA clinical reports
ISSN: 2363-9024
Titre abrégé: JA Clin Rep
Pays: Germany
ID NLM: 101682121
Informations de publication
Date de publication:
08 Sep 2021
08 Sep 2021
Historique:
received:
21
07
2021
accepted:
01
09
2021
revised:
25
08
2021
entrez:
8
9
2021
pubmed:
9
9
2021
medline:
9
9
2021
Statut:
epublish
Résumé
There are few cases of anaphylaxis after local application of fibrin sealant diagnosed by skin tests. A 49-year-old woman underwent partial lung resection under general anesthesia. Anesthesia was induced uneventfully. Shortly after applying absorbable suture reinforcement felt that contained fibrin sealant, her systolic blood pressure fell to approximately 70 mmHg, along with facial flushing. Anaphylaxis was diagnosed based on the clinical symptoms and high serum tryptase levels. Three months after the event, skin tests were performed with all agents and were positive only for fibrin sealant vial no. 2, whose main component is aprotinin. Subsequently, basophil activation tests using fibrin sealant vial no. 2 and pure aprotinin demonstrated that the causative agent was likely aprotinin. We diagnosed aprotinin-induced anaphylaxis using skin tests and basophil activation tests. The occurrence of anaphylaxis should be considered when changes in vital signs are observed after the use of fibrin sealant.
Sections du résumé
BACKGROUND
BACKGROUND
There are few cases of anaphylaxis after local application of fibrin sealant diagnosed by skin tests.
CASE PRESENTATION
METHODS
A 49-year-old woman underwent partial lung resection under general anesthesia. Anesthesia was induced uneventfully. Shortly after applying absorbable suture reinforcement felt that contained fibrin sealant, her systolic blood pressure fell to approximately 70 mmHg, along with facial flushing. Anaphylaxis was diagnosed based on the clinical symptoms and high serum tryptase levels. Three months after the event, skin tests were performed with all agents and were positive only for fibrin sealant vial no. 2, whose main component is aprotinin. Subsequently, basophil activation tests using fibrin sealant vial no. 2 and pure aprotinin demonstrated that the causative agent was likely aprotinin.
CONCLUSIONS
CONCLUSIONS
We diagnosed aprotinin-induced anaphylaxis using skin tests and basophil activation tests. The occurrence of anaphylaxis should be considered when changes in vital signs are observed after the use of fibrin sealant.
Identifiants
pubmed: 34495416
doi: 10.1186/s40981-021-00472-6
pii: 10.1186/s40981-021-00472-6
pmc: PMC8426421
doi:
Types de publication
Journal Article
Langues
eng
Pagination
68Subventions
Organisme : japan society for the promotion of science
ID : 17K16721
Organisme : japan society for the promotion of science
ID : 18K08809
Informations de copyright
© 2021. The Author(s).
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