title: Tranexamic Acid: An Exceedingly Rare Cause of Anaphylaxis during Anaesthesia.
abstract: Tranexamic acid (TXA) allergy is extremely rare. An 80-year-old woman without prior exposure to TXA underwent elective knee replacement. Shortly after induction of anaesthesia and intravenous TXA, she developed hypotension, tachycardia, and facial erythema accompanied by a raised serum tryptase. Later, skin prick and intradermal testing confirmed positive responses to TXA in high dilution and with negative results to the other drugs used. While neuromuscular blocking agents, opiates, and antibiotics remain the most frequent cause of anaphylaxis during anaesthesia, allergy to TXA should always be borne in mind and requires skin testing for confirmation as there are presently no blood tests available.
authors.affiliation: Department of Immunology and Allergy, St Helier Hospital, Carshalton, Surrey SM5 1AA, UK.
authors.forename: R A
authors.identifier: 0000-0002-2586-3422
authors.initials: RA
authors.lastname: Bansal
authors.affiliation: Department of Immunology and Allergy, St Helier Hospital, Carshalton, Surrey SM5 1AA, UK.
authors.forename: A
authors.initials: A
authors.lastname: Nicholas
authors.affiliation: Department of Immunology and Allergy, St Helier Hospital, Carshalton, Surrey SM5 1AA, UK.
authors.forename: A S
authors.identifier: 0000-0001-9263-231X
authors.initials: AS
authors.lastname: Bansal