title: [Fatal anaphylactic shock in a patient treated with beta-blockers].
abstract: The occurrence of an anaphylactoid shock in a patient treated with beta-adrenergic blocking agents during a long time prior to surgery constitutes a high risk because beta-receptors are refractory to adrenergic substances and compensatory mechanisms are obtunded. The shock is characterized by severe hypotension and bradycardia, both resistant to adrenaline. These signs were observed in a patient treated with metoprolol for hypertension several months prior to surgery. The intravenous injection of an iodine containing contrast medium during general anaesthesia was followed by a lethal anaphylactoid shock resistant to adrenaline, atropine and isoprenaline. The treatment of the shock needs, besides adrenaline, massive vascular filling, high doses of beta-agonists and glucagon.
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000707:Anaphylaxis / Q000139:chemically induced / Q000503:physiopathology*; D000768:Anesthesia, General; D001794:Blood Pressure / Q000187:drug effects; D003287:Contrast Media / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007482:Iothalamate Meglumine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
chemical_list: D000319:Adrenergic beta-Antagonists; D003287:Contrast Media; C001694:meglumine ioxithalamate; D007482:Iothalamate Meglumine
vernacular_title: Choc anaphylactoïde mortel chez un malade traité par bêta-bloquants.