Dextran syndrome. Acute hypotension, noncardiogenic pulmonary edema, anemia, and coagulopathy following hysteroscopic surgery using 32% dextran 70.
Dextran solutions are favored distending media for many hysteroscopic procedures because they are easy to administer, distribute uniformly within the uterine cavity, and are relatively nontoxic. We present the case of a 26-year-old woman who developed hypotension, noncardiogenic pulmonary edema, and hemorrhagic diathesis following hysteroscopic surgery with 32% dextran 70. A medical literature review indicates that following hysteroscopic surgery in which dextran solution has been used, "dextran syndrome" has been diagnosed in some patients. This syndrome is characterized by acute hypotension, hypoxia, coagulopathy, and anemia. We speculate on the pathogenesis of this condition and offer recommendations on how to evaluate and treat this rare dextran-related complication.
Ellingson
T L
TL
Division of Internal Medicine, Evertt Clinic, Wash, USA.
Aboulafia
D M
DM
D000208:Acute Disease; D000282:Administration, Intravaginal; D000328:Adult; D000740:Anemia / Q000139:chemically induced*; D001778:Blood Coagulation Disorders / Q000139:chemically induced*; D003911:Dextrans / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced*; D015907:Hysteroscopy; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000009:adverse effects*; D011654:Pulmonary Edema / Q000139:chemically induced*; D013577:Syndrome
D003911:Dextrans; D010952:Plasma Substitutes