title: A Case of Anaphylaxis to Patent Blue in a Patient with Sentinel Lymph Node Excision.
abstract: In medicine, patent blue violet (PBV) is utilized for staining lymphatic vessels in sentinel lymph node (SLN) surgery. Moreover, PBV (also called E131 ) is used as food additive. We report on a 51-year-old non-atopic female with early breast cancer, who was scheduled for SLN excision and experienced an intra-operative anaphylactic reaction. In diagnostics the skin prick test (SPT) was positive to PBV. Hypersensitivity reactions to PBV can arise after the first exposure in surgery as sensitization may arise from either PBV (E131) in foods (i.e. in sweets or blue curacao) or from other structurally closely related triarylmethane dyes in objects of everyday life like textiles, detergents, paints, cold remedies and cosmetics. This article supports the necessity of an increased awareness of the possibility of anaphylactic reactions to PBV during SLN surgery, even if the patient never had contact to PBV before.
authors.affiliation: Department of Dermatology, Venereology and Allergology, University Hospital, Leipzig, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Aurich
authors.affiliation: Department of Dermatology, Venereology and Allergology, University Hospital, Leipzig, Germany.
authors.forename: Anna-Theresa
authors.initials: AT
authors.lastname: Seitz
authors.affiliation: Department of Dermatology, Venereology and Allergology, University Hospital, Leipzig, Germany AND Helmholtz Centre for Environmental Research, Leipzig, Germany.
authors.forename: Janina
authors.initials: J
authors.lastname: Tomm
authors.affiliation: Department of Dermatology, Venereology and Allergology, University Hospital, Leipzig, Germany.
authors.forename: Jan-Christoph
authors.initials: JC
authors.lastname: Simon
authors.affiliation: Department of Dermatology, Venereology and Allergology, University Hospital, Leipzig, Germany.
authors.forename: Regina
authors.initials: R
authors.lastname: Treudler
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced*; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D004396:Coloring Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000139:chemically induced*; D008875:Middle Aged; D012394:Rosaniline Dyes / Q000009:adverse effects*; D021701:Sentinel Lymph Node Biopsy; D012882:Skin Tests
chemical_list: D004396:Coloring Agents; D012394:Rosaniline Dyes; C008769:sulfan blue
keywords: Allergy; Anaphylaxis; Blue dye; Breast cancer; E131; Patent blue violet; Sentinel lymph node excision