Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/33878
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Type: Journal article
Title: Pseudoanaphylaxis
Author: Russell, W.
Smith, W.
Citation: Anaesthesia and Intensive Care, 2006; 34(6):801-803
Publisher: Australian Soc Anaesthetists
Issue Date: 2006
ISSN: 0310-057X
1448-0271
Abstract: Profound hypotension and cardiac arrest after commencement of combined spinal and general anaesthesia in a patient for knee replacement surgery raised the suspicion of anaphylaxis. This seemed to be confirmed when a mast cell tryptase test taken about 90 minutes after the onset of the hypotension was elevated. However, subsequent intradermal skin testing twelve weeks later did not identify a causal drug. Repeat mast cell tryptase at the time showed the same elevation, which led to the correct diagnosis of mastocytosis and a secondary diagnosis that the patient’s hypotension and cardiac arrest were the result of her spinal anaesthesia. If the serum tryptase is elevated during the event but no allergic agent can be identified, a further serum tryptase should be taken several weeks later to exclude a persistent elevation due to mastocytosis.
Keywords: Mast Cells
Humans
Mastocytosis
Heart Arrest
Hypotension
Anaphylaxis
Intraoperative Complications
Diagnosis, Differential
Arthroplasty, Replacement, Knee
Middle Aged
Female
Tryptases
Clinical Enzyme Tests
Biomarkers
DOI: 10.1177/0310057x0603400618
Description (link): http://www.aaic.net.au/Article.asp?D=2006364
Appears in Collections:Anaesthesia and Intensive Care publications
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