title: Fatal anaphylactic reactions to lignocaine.
abstract: Fatal anaphylactic reactions to lignocaine are very rare. In this review of published reports, the main objective is to determine the characteristics of fatal allergic reactions to lignocaine and describe the forensic investigations of anaphylaxis related deaths. From 1957 to 2012, there were seven reports of single case and one report of 8 cases with sufficient information for review. Fatal anaphylactic reactions to lignocaine were generally characterised by fast onset of symptoms (within seconds to <30min of drug exposure) and rapid progression to cardiopulmonary arrest and death (23min to ∼1h). Features of cardiovascular, respiratory and neurological system involvements were often seen. Autopsy might reveal laryngeal oedema, pulmonary oedema, cerebral oedema, eosinophil infiltrates in many organs and other changes. Elevated blood tryptase level caused by mast cell degranulation was also used to diagnose acute anaphylaxis.
authors.affiliation: Division of Clinical Pharmacology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China; Centre for Food and Drug Safety, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: tykchan@cuhk.edu.hk.
authors.forename: Thomas Y K
authors.initials: TYK
authors.lastname: Chan
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced* / Q000473:pathology*; D001344:Autopsy; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects*
chemical_list: D008012:Lidocaine
keywords: Anaphylaxis; Fatal outcome; Lignocaine