Histamine levels and cardiovascular responses during splenectomy and splenorenal shunt formation in a patient with systemic mastocytosis.
Systemic mastocytosis is a rare disorder characterised by the infiltration of many tissues by abnormal numbers of mast cells. Life-threatening episodes of bronchospasm and hypotension are common in response to a variety of triggers which cause mast cell degranulation. We present the case history of a patient with severe mast cell disease who successfully underwent splenectomy and portocaval anastomosis. Peri-operative therapy was directed towards mast cell stabilisation, and histamine-releasing drugs were avoided. Cardiovascular data, together with blood histamine levels and thrombin times, indicated that mast cell degranulation did not occur. A review of the current literature concerning mast cell disease as it relates to anaesthesia is presented and suggestions for the safe management of such cases are given.
Smith
G B
GB
Yale University School of Medicine, New Haven, Connecticut 06510.
Gusberg
R J
RJ
Jordan
R H
RH
Kim
B
B
D000328:Adult; D006439:Hemodynamics; D006632:Histamine / Q000097:blood*; D006801:Humans; D008297:Male; D008415:Mastocytosis / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D013156:Splenectomy; D013164:Splenorenal Shunt, Surgical
D006632:Histamine