title: Anaphylactoid reactions in connection with infusion of invert sugar solutions are due to macromolecular contaminants.
abstract: 13 untoward mold anaphylactoid reactions were observed in patients infused with invert sugar solutions in Sweden during a 7-month period in 1973: an incidence of 1/31,000 infusions. Immunological and physicochemical analysis of invert sugar solutions and of the raw material, sucrose, revealed traces of native alpha-1,6-glucan with molecular weight of 10-100 millions as contaminant. This indicates, that the sucrose had been exposed to microbial contamination during its manufacture from sugar-beet or sugar-cane. Reversed single radial immunodiffusion was used for alpha-1,6-glucan detection and screening of all sucrose batches. Rejection of contaminated sucrose as raw material reduced the incidence of anaphylactoid invert sugar reactions to about 1/575,000 infusions. Examination of all sucrose raw material for traces of crude alpha-1,6-glucan is recommended as a test for detection of microbial contamination.
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced*; D003911:Dextrans / Q000009:adverse effects; D004340:Drug Contamination; D006801:Humans; D046911:Macromolecular Substances; D013395:Sucrose / Q000009:adverse effects*
chemical_list: D003911:Dextrans; D046911:Macromolecular Substances; D013395:Sucrose