Abstract
Anaphylactic reactions to blood transfusion can lead to life-threatening cardiovascular disruptions. We describe a case in which anaphylaxis due to blood transfusion during general anesthesia was the probable cause of coronary artery spasm. Thirty minutes after the transfusion of concentrated red blood cells, the patient’s blood pressure had dropped to 70/40 mmHg and peak airway pressure had increased to 35 cmH2O. The ST segment of the ECG was simultaneously elevated, and the left upper arm became extensively flushed. The tryptase concentration in the patient’s plasma collected 3 h postoperatively was 13.9 μg·l−1 (normal range, 2.1–9.0 μg·l−1). This case report emphasizes that anaphylactic reactions to blood transfusion can potentially lead to coronary artery spasm.
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References
Fujita Y, Chikamitsu M, Kimura M, Toriumi T, Endoh S, Sari A. An anaphylactic reaction possibly associated with an intraoperative coronary spasm during general anesthesia. J Clin Anesth. 2001;13:221–226.
Koshiba K, Hoka S. Clinical characteristics of perioperative coronary spasm: reviews of 115 case reports in Japan. J Anesth. 2001; 15:93–99.
Conraads VMA, Jorens PG, Ebo DG, Claeys MJ, Bosmans JM, Vrints CJ. Coronary artery spasm complicating anaphylaxis secondary to skin disinfectant. Chest. 1998;113:1417–1419.
Del Furia F, Querceto L, Testi S, Santoro GM. Acute ST-segment elevation myocardial infarction complicating amoxicillin-induced anaphylaxis: a case report. Int J Cardiol. 2007;117:e37–e39.
Mertes PM, Laxenaire M-C, Alla F; Group d’Etudes des Réactions Anaphylactoïdes Peranesthésiques. Anaphylactic and anaphylactoid reactions occurring during anesthesia in France in 1999–2000. Anesthesiology. 2003;99:536–545.
Gilstad CW. Anaphylactic transfusion reactions. Curr Opin Hematol. 2003;10:419–423.
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Osugi, T., Ueki, R., Shimode, N. et al. Blood transfusion-induced anaphylaxis and coronary artery spasm during general anesthesia. J Anesth 22, 457–459 (2008). https://doi.org/10.1007/s00540-008-0658-7
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DOI: https://doi.org/10.1007/s00540-008-0658-7