title: Anaphylaxis and other adverse reactions to blue dyes: a case series.
abstract: We report three cases of anaphylaxis during anaesthesia confirmed on intradermal testing to be related to patent blue V dye (Guerbet - Chemical Abstract Service 3536-49-0). All three cases were associated with moderate to severe hypotension. Two cases had delayed onset, and two were associated with a rash. None of the cases were associated with bronchospasm. In all three patients the interference with pulse oximetry readings contributed to difficulties in management. We recommend the use of a test dose of blue dye prior to surgery, as suggested in the manufacturer's product information. We also recommend high vigilance for possible allergic reactions when patent blue dyes are used for sentinel lymph node mapping, because the presentations may be atypical and the reduced pulse oximetry readings may be a distraction.
authors.affiliation: Department of Anaesthesia, Princess Alexandra Hospital, Brisbane, Queensland, Australia. jdhoward_mowat@yahoo.com.au
authors.forename: J D
authors.initials: JD
authors.lastname: Howard
authors.forename: V
authors.initials: V
authors.lastname: Moo
authors.forename: P
authors.initials: P
authors.lastname: Sivalingam
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced*; D004396:Coloring Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000503:physiopathology; D007428:Intradermal Tests; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D012394:Rosaniline Dyes / Q000008:administration & dosage / Q000009:adverse effects*; D012720:Severity of Illness Index
chemical_list: D004396:Coloring Agents; D012394:Rosaniline Dyes; C008769:sulfan blue