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Órgano Oficial del Colegio Mexicano de Alergia, Asma e Inmunología Pediátrica y de la Asociación Latinoamericana de Pediatría

2016, Number 3

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Alerg Asma Inmunol Pediatr 2016; 25 (3)

Transcendence of the activation of basophils test in allergy to anesthetics. Are the skin tests enough? Case report and literature review

Venegas-Montoya E, López-Pérez GT, Mendoza-Hernández D

Language: Spanish
References: 6
Page: 106-110
PDF size: 221.92 Kb.


ABSTRACT

Hypersensitivity reactions to anesthesia are rare, but are associated with significant morbidity and mortality. Confirming the diagnosis is complex due to the large number of drugs administered to the patient at the same time, making it difficult to identify the causative agent. The incidence is 1 in 1,250 to 1 in 10,000, with a fatal outcome that varies by country, from 4% in the US to 1.4% in Australia. Skin test and basophil activation test are included within the diagnostic approach, which has specificity of 90%, making BAT a useful alternative to confirm the diagnosis if skin test result is negative or difficult to interpret. The following case, a three year old female with history of perioperative anaphylaxis, is shown to illustrate that, despite the initial approach with negative skin tests, the test activation of basophil is positive, highlighting the importance to reach the final diagnostic option given the magnitude of the response of the patient and the high risk of a new anaphylactic reaction with fatal outcome.


REFERENCES

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  2. Kannan JA, Bernstein JA. Perioperative anaphylaxis: diagnosis, evaluation, and management. Immunol Allergy Clin North Am. 2015; 35 (2): 321-334.

  3. Volcheck GW, Mertes PM. Local and general anesthetics immediate hypersensitivity reactions. Immunol Allergy Clin North Am. 2014; 34 (3): 525-546, viii.

  4. Mertes PM, Demoly P, Malinovsky JM. Hypersensitivity reactions in the anesthesia setting/allergic reactions to anesthetics. Curr Opin Allergy Clin Immunol. 2012; 12 (4): 361-368.

  5. Mertes PM, Alla F, Trechot P et al. Anaphylaxis during anesthesia in France: an 8-year national survey. J Allergy Clin Immunol. 2011; 128 (2): 366-373.

  6. Mertes PM, Tajima K, Regnier-Kimmoun MA et al. Perioperative anaphylaxis. Med Clin North Am. 2010; 94 (4): 761-789, xi.




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