Severe anaphylactic shock with methylene blue instillation.
We report a documented severe immunoglobulin E-mediated hypersensitivity reaction associated with use of 1% methylene blue for detection of tubal permeability occurring during general anesthesia. Clinical symptoms, biological assessment results, and cutaneous test positivity confirmed an anaphylactic reaction to methylene blue. This case report confirms the need for systematic allergological investigation of all drugs and substances administered during the perioperative period in the event of a hypersensitivity reaction occurring during anesthesia. Anesthesiologists should be aware of the possibility of hypersensitivity reactions involving any drug or substance used during surgery.
Service d'anesthésie-réanimation chirurgicale Hôpital Central CHU 29 Avenue du Maréchal de Lattre de Tassigny 54035 Nancy France. pascale.dewachter@wanadoo.fr
Pascale
P
Dewachter
Claudie
C
Mouton-Faivre
Philippe
P
Tréchot
Jean-Claude
JC
Lleu
Paul Michel
PM
Mertes
D000328:Adult; D000707:Anaphylaxis / Q000209:etiology*; D000768:Anesthesia, General; D005184:Fallopian Tube Diseases / Q000175:diagnosis / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures; D006632:Histamine / Q000097:blood; D006636:Histamine Release / Q000187:drug effects; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007962:Leukocytes / Q000187:drug effects / Q000378:metabolism; D008751:Methylene Blue / Q000009:adverse effects*; D012882:Skin Tests; D014581:Urticaria / Q000209:etiology
D007073:Immunoglobulin E; D006632:Histamine; D008751:Methylene Blue