Anaphylaxis to human serum albumin.
During her 26th week of pregnancy a 20-year-old woman developed generalized pruritus, urticaria, flushing, tinnitus, and tachycardia during plasmapheresis with 5% human serum albumin (HSA) as adjunctive treatment for anti-Kell isoimmunization. The reaction was controlled with intravenous diphenhydramine. Despite pretreatment with diphenhydramine and betamethasone a subsequent attempt to perform plasmapheresis with infusion of 5% HSA resulted in a more severe reaction which progressed to respiratory distress. Intradermal skin testing with 5% HSA produced a 9 x 11-mm wheal and 17 x 21-mm erythema at 15 minutes. An enzyme-linked immunoassay was positive for IgE antibody to 5% HSA before and after dialysis for removal of Na caprylate. These results are consistent with an IgE-mediated basis for this patient's reaction to HSA.
Stafford
C T
CT
Medical College of Georgia, Augusta.
Lobel
S A
SA
Fruge
B C
BC
Moffitt
J E
JE
Hoff
R G
RG
Fadel
H E
HE
D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced* / Q000188:drug therapy; D004155:Diphenhydramine / Q000008:administration & dosage / Q000627:therapeutic use; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007626:Kell Blood-Group System; D010956:Plasmapheresis; D011247:Pregnancy; D012709:Serum Albumin / Q000009:adverse effects*
D007626:Kell Blood-Group System; D012709:Serum Albumin; D004155:Diphenhydramine