title: Anaphylaxis to human serum albumin.
abstract: 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.
authors.affiliation: Medical College of Georgia, Augusta.
authors.forename: C T
authors.initials: CT
authors.lastname: Stafford
authors.forename: S A
authors.initials: SA
authors.lastname: Lobel
authors.forename: B C
authors.initials: BC
authors.lastname: Fruge
authors.forename: J E
authors.initials: JE
authors.lastname: Moffitt
authors.forename: R G
authors.initials: RG
authors.lastname: Hoff
authors.forename: H E
authors.initials: HE
authors.lastname: Fadel
mesh_terms: 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*
chemical_list: D007626:Kell Blood-Group System; D012709:Serum Albumin; D004155:Diphenhydramine