Sugammadex hypersensitivity-a case of anaphylaxis

We describe a case of a patient undergoing open abdominal aneurysm surgery who developed a severe, life-threatening allergic reaction immediately after administration of sugammadex. The manifestation was purely a cardiovascular collapse. The mainstay of treatment was administration of high-dose adre...

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Bibliographic Details
Published in:Anaesthesia and intensive care 2014-01, Vol.42 (1), p.89-92
Main Authors: Jeyadoss, J, Kuruppu, P, Nanjappa, N, Van Wijk, Rraw
Format: Article
Language:English
Subjects:
Anaphylaxis - chemically induced
Anaphylaxis - therapy
Aortic Aneurysm, Abdominal - surgery
Drug Hypersensitivity - etiology
gamma-Cyclodextrins - adverse effects
Humans
Male
Middle Aged
Neuromuscular Blockade
Sugammadex
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Summary:We describe a case of a patient undergoing open abdominal aneurysm surgery who developed a severe, life-threatening allergic reaction immediately after administration of sugammadex. The manifestation was purely a cardiovascular collapse. The mainstay of treatment was administration of high-dose adrenaline and fluid resuscitation. The diagnosis of anaphylaxis was supported by a positive serum mast cell tryptase (93 µg/l) at one hour post-event. Sugammadex was confirmed as the cause of the anaphylaxis by a positive intradermal allergy test (25 mm diameter response to 1:100 dilution), with a normal saline control and a negative response to the other drugs used during the event. This case report is a reminder that the use of sugammadex is associated with rare but serious risks.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057x1404200115