Research article summary (published 30 Oct 2003):

Screening for mast cell tryptase and serum IgE antibodies in 18 patients with anaphylactic shock during general anaesthesia.

Full Abstract

BACKGROUND: In the perioperative setting multiple agents can cause anaphylaxis. Often the reactions are dramatic, and due to their lifethreatening potential it is crucial that the responsible agent is identified in order to avoid future adverse reactions. The aim of the present study was to measure the concentration of serum mast cell tryptase (MCT), to investigate the prevalence of serum IgE antibodies against ammonium groups, choline, morphine, suxamethonium, thiopentone and latex and to perform skin prick tests (SPTs) in 18 patients experiencing an anaphylactic reaction during induction of general anaesthesia. METHODS: Serum samples from 18 patients with an anaphylactic reaction during general anaesthesia were analyzed for MCT and specific IgE against ammonium groups, choline, morphine, suxamethonium, thiopentone and latex. Skin prick tests were performed in 11 out of 18 patients. RESULTS: Ten patients had elevated MCT levels and specific IgE against ammonium ion, morphine and (with the exception of patient nos 3, 9 and 10) suxamethonium. Seven of these patients had positive SPTs to suxamethonium. One of the patients tested positive to latex in addition to suxamethonium. Two patients showed elevated MCT, while specific IgE against the drugs tested was not detected. Three patients tested positive to ammonium ion, morphine and suxamethonium, but negative to MCT. Three patients tested negative to both MCT and specific IgE. CONCLUSIONS: Fifteen out of 18 sera tested positive for MCT and/or specific IgE against neuromuscular blocking drugs (NMBDs). Ten of the 18 patients experienced an IgE-mediated anaphylactic reaction to NMBDs during anaesthesia, verified by detection of specific IgE and elevated levels of MCT.

Author information

Author/s: Dybendal, T (T); Guttormsen, A B (AB); Elsayed, S (S); Askeland, B (B); Harboe, T (T); Florvaag, E (E);

Affiliation: Haukeland Hospital Pharmacy, Haukeland University Hospital, Bergen, Norway. sykehusapoteket.kongsvinger(-atsign-)apotek.no

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Acta anaesthesiologica Scandinavica (Acta Anaesthesiol Scand), published in Denmark. (Language: eng)

Reference: 2003-Nov; vol 47 (issue 10) : pp 1211-8

Dates: Created 2003/11/17; Completed 2004/04/01; Revised 2006/11/15;

PMID: 14616317, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult Analgesics, Opioid - immunology Anaphylaxis - blood; chemically induced; diagnosis; immunology Anesthesia, General Anesthetics, Intravenous - immunology Biological Markers - blood Choline - immunology Drug Hypersensitivity - blood; diagnosis; immunology Female Humans Immunoglobulin E - blood Latex - immunology

Latex - immunology Male Mast Cells - enzymology Morphine - immunology Neuromuscular Blocking Agents - adverse effects; immunology Neuromuscular Depolarizing Agents - immunology Quaternary Ammonium Compounds - immunology Serine Endopeptidases - blood Skin Tests Succinylcholine - immunology Thiopental - immunology Tryptases

Associated Chemicals: Analgesics, Opioid (0) ; Anesthetics, Intravenous (0) ; Biological Markers (0) ; Latex (0) ; Neuromuscular Blocking Agents (0) ; Neuromuscular Depolarizing Agents (0) ; Quaternary Ammonium Compounds (0) ; Succinylcholine (306-40-1) ; Immunoglobulin E (37341-29-0) ; Morphine (57-27-2) ; Choline (62-49-7) ; Thiopental (76-75-5) ; Serine Endopeptidases (EC 3.4.21.-) ; Tryptases (EC 3.4.21.59)

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