Cross-reactivity among amide-type local anesthetics in a case of allergy to mepivacaine.
Among the various adverse reactions to local anesthetics, IgE-mediated reactions, particularly to the more commonly used amide group, are extremely rare. We report the case of a 39-year-old man who suffered itching and generalized urticaria with facial angioedema 15 minutes after administration of mepivacaine. Skin tests revealed a strong positive reaction to mepivacaine, lidocaine, and ropivacaine, but negative reactions to bupivacaine and levobupivacaine. Furthermore, double-blind placebo-controlled subcutaneous challenge with bupivacaine and levobupivacaine was well tolerated. We conclude that an extensive allergologic study must be carried out in rare cases of true allergic reaction to amide-type local anesthetics in order to rule out cross reactivity.
González-Delgado
P
P
Sección Alergia, Hospital General de Alicante, Aliccante, Spain. gonzalez_pur@gva.es
Antón
R
R
Soriano
V
V
Zapater
P
P
Niveiro
E
E
D000328:Adult; D000779:Anesthetics, Local / Q000009:adverse effects* / Q000276:immunology; D003429:Cross Reactions; D004311:Double-Blind Method; D004342:Drug Hypersensitivity / Q000209:etiology*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D008619:Mepivacaine / Q000009:adverse effects* / Q000276:immunology
D000779:Anesthetics, Local; D007073:Immunoglobulin E; D008619:Mepivacaine