title: Fatal anaphylactic reaction to protamine after femoropopliteal by-pass surgery.
abstract: OBJECTIVE
  Administration of protamine might cause serious complications especially in patients treated preoperatively with NPH insulin.
  
  
  METHODS
  A case report.
  
  
  CONCLUSIONS
  Administration of protamine sulphate caused fatal anaphylactic reaction to a diabetic patient undergoing femoropopliteal by-pass surgery. Care should be taken when administering protamine to a patient treated preoperatively with NPH insulin and the possibility of an anaphylactid reaction to protamine have to be kept in mind.
authors.affiliation: Department of Surgery University Hospital of Kuopio, Finland. tapio.hakala@kolumbus.fi
authors.forename: T
authors.initials: T
authors.lastname: Hakala
authors.forename: R
authors.initials: R
authors.lastname: Suojaranta-Ylinen
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy; D004347:Drug Interactions; D017809:Fatal Outcome; D005263:Femoral Artery / Q000601:surgery; D006494:Heparin Antagonists / Q000009:adverse effects*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007336:Insulin, Isophane / Q000627:therapeutic use*; D007383:Intermittent Claudication / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011479:Protamines / Q000009:adverse effects*
chemical_list: D006494:Heparin Antagonists; D007004:Hypoglycemic Agents; D011479:Protamines; D007336:Insulin, Isophane