[Anaphylactic shock from succinylcholine, complicated by a rhabdomyolysis].
A young woman, with a contact dermatitis to nickel, experienced a life threatening anaphylaxis after induction of general anaesthesia for an emergency curettage. Hypersensitivity reaction involving IgE antibodies against succinylcholine was proven by positive skin test and radioimmunoassay detection of antibodies against succinylcholine and quaternary ammonium. After restoration of haemodynamics in a few hours, the patient had rhabdomyolysis predominant at lower left leg, which required a fasciotomy. An haemodialysis session was necessary, renal function being normalized thereafter. Several months later, the patient suffers from dysesthesia on the leg and foot. Muscular ischaemia was the consequence of the shock, the external compression due to the compression stockings probably being an additional factor.
Rocchiccioli
C
C
Service d'anesthésie, hôpital Foch, 40, rue Worth, BP 36, 92150 Suresnes, France.
Aldea
R
R
Guinnepain
M-T
MT
Fischler
M
M
D000022:Abortion, Spontaneous / Q000601:surgery; D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy; D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D019299:Decompression, Surgical; D004107:Dilatation and Curettage; D004630:Emergencies; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000601:surgery; D007866:Leg / Q000098:blood supply; D009069:Movement Disorders / Q000209:etiology; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects* / Q000276:immunology; D010292:Paresthesia / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D011247:Pregnancy; D006435:Renal Dialysis; D012206:Rhabdomyolysis / Q000209:etiology*; D013390:Succinylcholine / Q000009:adverse effects* / Q000276:immunology; D016683:Supine Position / Q000502:physiology
D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine; D004837:Epinephrine