title: Hetastarch allergy and positive latex radioallergosorbent test in a patient suffering cardiovascular decompensation during multiple perioperative periods.
abstract: The cause of sudden cardiovascular collapse in the perioperative period can be elusive. Allergy may be overlooked as a cause. When allergy is considered, latex is often suspected. Because hetastarch is frequently used in situations involving hypovolemia and hypotension, and because allergic reactions to it are rare, it may be overlooked as a possible allergen. We report a case of a patient suffering cardiovascular decompensation during four nonconsecutive perioperative periods before it was determined that she was allergic to hetastarch. She also had a very highly positive latex radioallergosorbent test, suggesting a latex allergy.
authors.affiliation: *Division of Anesthesiology, Critical Care Medicine, and Comprehensive Pain Management, The Cleveland Clinic Foundation, and †Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, The Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: R Michael
authors.initials: RM
authors.lastname: Ritchey
authors.forename: Robert F
authors.initials: RF
authors.lastname: Helfand
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Irefin
authors.forename: Maged
authors.initials: M
authors.lastname: Argalious
authors.forename: John E
authors.initials: JE
authors.lastname: Tetzlaff
mesh_terms: D000368:Aged; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects*; D020315:Latex Hypersensitivity / Q000150:complications*; D011852:Radioallergosorbent Test; D012769:Shock / Q000209:etiology*
chemical_list: D006895:Hydroxyethyl Starch Derivatives