title: Blood transfusion-induced anaphylaxis and coronary artery spasm during general anesthesia.
abstract: Anaphylactic reactions to blood transfusion can lead to life-threatening cardiovascular disruptions. We describe a case in which anaphylaxis due to blood transfusion during general anesthesia was the probable cause of coronary artery spasm. Thirty minutes after the transfusion of concentrated red blood cells, the patient's blood pressure had dropped to 70/40 mmHg and peak airway pressure had increased to 35 cmH2O. The ST segment of the ECG was simultaneously elevated, and the left upper arm became extensively flushed. The tryptase concentration in the patient's plasma collected 3 h postoperatively was 13.9 microg x l(-1) (normal range, 2.1-9.0 microg x l(-1)). This case report emphasizes that anaphylactic reactions to blood transfusion can potentially lead to coronary artery spasm.
authors.affiliation: Department of Anesthesiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Osugi
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Ueki
authors.forename: Noriko
authors.initials: N
authors.lastname: Shimode
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Tatara
authors.forename: Chikara
authors.initials: C
authors.lastname: Tashiro
mesh_terms: D000368:Aged; D000707:Anaphylaxis / Q000209:etiology*; D000768:Anesthesia, General; D003329:Coronary Vasospasm / Q000209:etiology*; D003402:Creatine Kinase / Q000378:metabolism; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D006801:Humans; D008297:Male; D065227:Transfusion Reaction; D053802:Tryptases / Q000097:blood
chemical_list: D003402:Creatine Kinase; D053802:Tryptases