論文

2020年8月

Interpreting the results of early skin tests after perioperative anaphylaxis requires special attention: a case report and review of literature.

Journal of anesthesia
  • Masaki Orihara
  • ,
  • Tomonori Takazawa
  • ,
  • Kazuhiro Nagumo
  • ,
  • Shinya Sakamoto
  • ,
  • Tatsuo Horiuchi
  • ,
  • Shigeru Saito

34
4
開始ページ
624
終了ページ
629
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00540-020-02802-x

Skin tests are the gold standard for detecting the culprit drug of anaphylaxis, and should ideally be performed after an interval of 4-6 weeks after the reaction to avoid false-negative results. However, when re-operation cannot be delayed and early allergy tests are necessary, special attention is required during subsequent anesthesia, because early skin tests tend to produce false-negative results. This report presents a case of rocuronium-induced anaphylaxis in which early skin tests showed negative results for all the drugs tested. The second anesthesia was safely performed by avoiding all the drugs used for the first anesthesia. Ultimately, skin tests and basophil activation tests (BATs) performed after re-operation demonstrated rocuronium as the drug responsible for anaphylaxis. We recommend performing BATs in addition to skin tests to improve the accuracy of diagnosis of anaphylaxis. In this report, we also discuss interpretation of the results of early skin tests and subsequent selection of drugs for anesthesia. After postponement of surgery due to anaphylaxis, we are often required to perform allergy tests at an early stage if re-operation cannot be delayed. In such cases, skin test results alone should not be used to guide subsequent anesthesia management to avoid recurrent anaphylaxis.

リンク情報
DOI
https://doi.org/10.1007/s00540-020-02802-x
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32476042
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378110
ID情報
  • DOI : 10.1007/s00540-020-02802-x
  • PubMed ID : 32476042
  • PubMed Central 記事ID : PMC7378110

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