Intraoperative anaphylactic shock in a child with no history of type I hypersensitivity.
Natural rubber latex is the second most implicated agent in intraoperative anaphylactic reactions. This report describes a case of intraoperative anaphylaxis occurring in a non-atopic fourteen-year-old girl undergoing multiple surgical procedures, but without spina bifida, in which latex surgical gloves were the main culprit for the anaphylactic reactions. Clinical manifestations of an anaphylactic reaction were also experienced during the examination of the possible cause of intraoperative anaphylaxis by skin prick testing with a latex allergen extract. Skin tests with anesthetics were negative. Specific IgE to latex was positive at 92.9 kUA/L (class 5). The molecular basis for the reported intraoperative anaphylaxis was ascribed to three low-molecular mass latex allergens (10-15 kD) detected in the brand of latex surgical gloves used during the operation. Given the potential of a dramatic outcome, latex allergy testing as a regular preoperative measure may contribute to the reduction of anaphylactic reactions during surgical interventions.
Department of Allergology and Pulmonology, University Children's Hospital, Belgrade, Serbia. marinaa@EUnet.yu
Marina
M
Atanasković-Marković
Marija
M
Gavrović-Jankulović
Tanja
T
Cirković Velicković
Olja
O
Vucković
Petar
P
Ivanovski
Branimir
B
Nestorivić
Goran
G
Cuturilo
Dusica
D
Simić
D000293:Adolescent; D000707:Anaphylaxis / Q000097:blood / Q000139:chemically induced* / Q000276:immunology*; D005260:Female; D005932:Gloves, Surgical / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D007431:Intraoperative Complications / Q000097:blood / Q000139:chemically induced / Q000276:immunology*; D020315:Latex Hypersensitivity / Q000097:blood / Q000276:immunology*; D012408:Rubber / Q000009:adverse effects*; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000276:immunology / Q000601:surgery*; D014581:Urticaria / Q000276:immunology; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000276:immunology / Q000601:surgery*
D007073:Immunoglobulin E; D012408:Rubber