title: Suspected recurrent anaphylaxis in different forms during general anesthesia.
abstract: We report on a patient who presented with recurrent severe shock during general anesthesia. The patient was a man scheduled for lung surgery whose first attack was a coronary spasm, which was followed by a second shock with severe bronchospasm and hypotension 4 weeks later. An elevated serum tryptase concentration was observed, and subsequent skin testing revealed negative reactions to some drugs administered in this case. This case serves to alert anesthetists to the possibility of some different forms of allergy and highlights the importance of rigorous investigation of all the reagents and phenomena.
authors.affiliation: Department of Anesthesiology, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Imanishi
authors.forename: Akira
authors.initials: A
authors.lastname: Kitamura
authors.forename: Kouichi
authors.initials: K
authors.lastname: Maruyama
authors.forename: Jun
authors.initials: J
authors.lastname: Ariyama
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nishibe
authors.forename: Masakazu
authors.initials: M
authors.lastname: Hayashida
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Usuda
mesh_terms: D000368:Aged; D000707:Anaphylaxis / Q000209:etiology*; D000768:Anesthesia, General / Q000009:adverse effects*; D001986:Bronchial Spasm / Q000276:immunology; D003329:Coronary Vasospasm / Q000276:immunology; D004342:Drug Hypersensitivity / Q000209:etiology; D006801:Humans; D007022:Hypotension / Q000276:immunology; D007431:Intraoperative Complications; D008168:Lung / Q000601:surgery; D008297:Male; D055502:Secondary Prevention; D012769:Shock / Q000209:etiology; D012882:Skin Tests