03-02-2009, 12:50
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#1
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Guerrilla
Join Date: Jan 2008
Location: Northeast
Posts: 150
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Interesting Incidences of Anaphylaxis
Everyone,
During my normal monthly reading of the various medical journals I caught a one of the more recent case reports in the Journal Of Emergency Medicine. It highlights a case in Turkey where
Quote:
Originally Posted by American Journal of Emergency Medicine (2009) 27, 130.e1–130.e2, Didem Ay MD, Can Aktas MD, Sezgin Sarikaya MD, Asli Cetin MD, Yeditepe University, Emergency Department Istanbul, Turkey, E-mail address: aydidem@yahoo.com
We present a 37-year-old woman who developed an anaphylactic reaction to normal saline infusion during evaluation for her acute abdominal pain.
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. Noting that this is an exceptionally rare condition it got me to wondering what if any rare cases of anaphylactic-anaphylactoid reactions you all may have encountered in your practice?
Last edited by ACE844; 03-02-2009 at 13:54.
Reason: edited to add anaphylactic-anaphylactoid to the end of my post due to the great point made by the poster below!
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ACE844 is offline
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03-02-2009, 13:32
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#2
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Guerrilla
Join Date: Sep 2007
Location: Nashville
Posts: 310
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Yeah, that's weird and rare.
If you'll permit me, "Anaphylaxis" is a Gell & Coombs Type 1 (Immediate) Hypersensitivity that is IgE mediated while "Anaphylactoid" is non-IgE mediated.
Great case!!
I haven't been able to access the article yet, but I wonder if something else was going on - latex, sepsis, etc....
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Last edited by olhamada; 03-02-2009 at 13:52.
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03-02-2009, 14:17
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#3
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Guerrilla Chief
Join Date: Jul 2004
Location: Phoenix, AZ
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macromolecule, viral or bacterial comtamination of the bag is most likely the source (playing the odds) rather than a true anaphylactic rxn....antibody tests /serology or cultures will answer this one.
ss
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03-02-2009, 14:30
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#4
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Area Commander
Join Date: Dec 2007
Location: UK
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if it worth saying, it will be quoted.
Last edited by Red Flag 1; 03-17-2018 at 08:48.
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03-02-2009, 15:44
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#5
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Guerrilla
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For those who are interested, here is the full text .pdf of the article.
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ACE844 is offline
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03-02-2009, 15:59
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#6
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Guerrilla
Join Date: Sep 2007
Location: Nashville
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Wow - very interesting. As I was reading, my differential included Ovarian Hyperstimulation Syndrome and metaclopramide (Reglan), but the authors seemed to address both of those adequately. Could it be a "macromolecule" as SWATSurgeon suggests from the plastic (polymer) IV bag or tubing? If that were the case, it seems that the D5 would have had a similar effect. 
__________________
"And dying in your beds many years from now, would you be willing to trade all the days from this day to that for one chance, just one chance to come back here and tell our enemies that they may take our lives, but they'll never take our freedom?"- Braveheart
de Oppresso Liber
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03-02-2009, 19:54
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#7
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Guerrilla
Join Date: Nov 2006
Location: Ohio, West Virginia
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Another consideration would be latex in the IV solution bags. These have largely been eliminated in most US hospitals so we can be as latex-free as possible, but it's possible that this Turkish hospital has not been as diligent about eliminating latex from most patient care areas. As recently as 10 years ago, these were very common in US hospitals, and can probably still be found in many. The fact that she didn't react badly to the D5 isn't that telling, since the D5 may be from a different manufacturer.
'zilla
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