Anaphylactic reaction to tranexamic acid in an adolescent undergoing posterior spinal fusion.
Tranexamic acid is an anti-fibrinolytic agent frequently used in pediatric surgery. Common side effects include nausea, flushing, and headache, but in rare instances, it may produce anaphylaxis; with only one previously reported case in a 72-year-old man. We report a case of a delayed anaphylactic reaction in a pediatric patient undergoing posterior spine fusion; and discuss the intraoperative management of the acute event, immunologic confirmation, and subsequent anesthetic approach.
Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
Jennifer
http://orcid.org/0000-0003-4363-9157
J
Chiem
Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
Iskra
I
Ivanova
Department of Immunology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
Andrew
A
Parker
Department of Orthopedic Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
Walter
W
Krengel
Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
Nathalia
N
Jimenez
D000293:Adolescent; D000707:Anaphylaxis / Q000209:etiology* / Q000628:therapy*; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D000933:Antifibrinolytic Agents / Q000009:adverse effects*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000628:therapy; D007431:Intraoperative Complications / Q000628:therapy*; D008297:Male; D016343:Monitoring, Intraoperative; D012882:Skin Tests; D013123:Spinal Fusion; D014148:Tranexamic Acid / Q000009:adverse effects*
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
anaphylaxis; antifibrinolytic agents; pediatrics; scoliosis; spinal fusion; tranexamic acid