Persistence of allergy to anaesthetic drugs.
Intradermal testing and RIA testing for specific IgE antibodies to neuromuscular blocking drugs (NMBDs) were performed in patients referred to an Anaesthetic Allergy Clinic. Six patients were initially investigated four to 29 years after clinical anaphylaxis during anaesthesia and two of these patients and sixteen others were investigated by intradermal testing on two occasions at least four years apart. Seven patients had RIA tests for NMBD-specific IgE antibodies on two occasions at the time of skin testing. In all but two patients the evidence for drug-specific antibodies persisted 4-29 years after the reactions. In one patient all tests became negative and in another the skin test became negative but the positive RIA persisted. Evidence of antibodies to NMBDs persisted in 21 of 22 patients who had had anaphylactic reactions to these drugs during anaesthesia. In the absence of evidence of allergy diminishing with time in the majority of patients it would seem wise to avoid drugs responsible for reactions for the rest of the patient's life.
Fisher
M M
MM
Intensive Therapy Unit, Royal North Shore Hospital, St. Leonards, New South Wales, Australia.
Baldo
B A
BA
D000443:Alcuronium / Q000009:adverse effects / Q000032:analysis; D000707:Anaphylaxis / Q000175:diagnosis / Q000378:metabolism; D000906:Antibodies / Q000032:analysis; D003650:Decamethonium Compounds / Q000009:adverse effects / Q000032:analysis; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000378:metabolism; D005703:Gallamine Triethiodide / Q000009:adverse effects / Q000032:analysis; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects* / Q000032:analysis; D011863:Radioimmunoassay; D012882:Skin Tests; D013390:Succinylcholine / Q000009:adverse effects / Q000032:analysis; D013997:Time Factors; D014403:Tubocurarine / Q000009:adverse effects / Q000032:analysis
D000906:Antibodies; D003650:Decamethonium Compounds; D009466:Neuromuscular Blocking Agents; D007073:Immunoglobulin E; C033019:decamethonium; D013390:Succinylcholine; D005703:Gallamine Triethiodide; D000443:Alcuronium; D014403:Tubocurarine