engleski

Near fatal systemic anaphylaxis-case report

Allergic reactions occuring under general anaesthesia increase the need for creating an effective strategy for their management. This is an increasing problem in Croatia, since there is no current data on incidence of this potencially fatal condition. Muscle relaxants are most comonly responsible for intraoperative allergic reactions in general population, while natural rubber latex is not recognised as the second most common cause with an alarmingly increasing incidence. Literature data shows that during first 10 minutes of an anaphylactic episode, it is seldom possible to make a correct diagnosis and because of that, no structured plan for treatment was ever devised. In order to stress out the need for identification of high risk patients, we present a 36-year-old woman who developped a nesr-fatal systemic anaphylaxis during an appendectomy followed by severe hypotension and erythema of the skin. Later on she went into cardiac arrest twice during a postoperative treatment in the Intensive Care Unit. After discharge the patient was referred to an allergist to identify the cause of anaphylaxis, since she was asymptomatic prior to the incident. Immunological in vitro tests revealed an elevated level of total IgE (408.8 kU/L) and a significantly elevated level of latex specific IgE (>100 kU/L). Prick test and in vivo challenge to general and local anaesthetics was negative.

latex; anaphylaxis

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