title: [An anaphylactic shock case after hepatic arterial infusion of zinostatin stimalamer suspension improved by anti-histaminics].
abstract: A 47-year-old man with hepatocellular carcinoma (HCC) at anterior and medical segment in the liver was treated with hepatic arterial infusion of Zinostatin Stimalamer-lipiodol suspension (SMANCS). After the 2nd infusion of SMANCS, the accumulation of lipiodol in the tumor was not good (Grade II), so additional administration was undertaken at five-weeks intervals. His systolic blood pressure immediately decreased from 120 to 60 mmHg, and he had numbness of hands, shaking chills, sweating, chest pain and numerous urticaria-like red exanthema. In spite of treatment by anti-shock agents such as steroid and catecholamines, these symptoms did not disappear, but antihistaminics greatly improved them without any serious side effects. Because of the remarkable effects of the antihistaminics and possibility of antibody production (IgE) after repeated infusions of high molecular SMANCS, this patient may have suffered anaphylactic shock caused by massive histamine release from mast cells.
authors.affiliation: 1st Dept. of Surgery, Tohoku University School of Medicine.
authors.forename: K
authors.initials: K
authors.lastname: Fukuhara
authors.forename: M
authors.initials: M
authors.lastname: Suzuki
authors.forename: M
authors.initials: M
authors.lastname: Unno
authors.forename: T
authors.initials: T
authors.lastname: Rikiyama
authors.forename: N
authors.initials: N
authors.lastname: Sakamoto
authors.forename: H
authors.initials: H
authors.lastname: Takeuchi
authors.forename: T
authors.initials: T
authors.lastname: Uchiyama
authors.forename: T
authors.initials: T
authors.lastname: Yamaki
authors.forename: H
authors.initials: H
authors.lastname: Iwasashi
authors.forename: H
authors.initials: H
authors.lastname: Kodama
authors.forename: S
authors.initials: S
authors.lastname: Matsuno
mesh_terms: D000707:Anaphylaxis / Q000188:drug therapy* / Q000209:etiology; D006528:Carcinoma, Hepatocellular / Q000628:therapy; D006499:Hepatic Artery; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D007261:Infusions, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000628:therapy; D008297:Male; D008299:Maleic Anhydrides / Q000009:adverse effects*; D008875:Middle Aged; D011137:Polystyrenes / Q000009:adverse effects*; D009353:Zinostatin / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D006634:Histamine H1 Antagonists; D008299:Maleic Anhydrides; D011137:Polystyrenes; C035755:poly(maleic acid-styrene)neocarzinostatin; D007459:Iodized Oil; D009353:Zinostatin