Diagnostic procedure after an immediate hypersensitivity reaction in the operating room.

Diagnostic procedure after an immediate hypersensitivity reaction in the operating room. Presse Med. 2016 Jun 30; Authors: Tacquard C, Laroche D, Stenger R, Mariotte D, Uring-Lambert B, De Blay F, Malinovsky JM, Mertes PM Abstract The diagnosis of a perioperative allergic reaction is based on clinical features associated with a suggestive timeline, the exclusion of other diagnoses, elevated concentrations of degranulation markers (histamine, tryptase), and positive allergy assessments (skin tests, specific IgE). After initiating appropriate treatment, the anesthesiologist should take blood samples to measure histamine and tryptase concentrations just after the reaction and repeat them 1-2hours later to validate the diagnosis of immediate hypersensitivity. A delayed measurement of basal tryptase is useful to rule out mastocytosis and to interpret moderate tryptase levels. The anesthesiologist must inform the patient of the reaction to obtain adhesion and consent to subsequent investigations and must record the timing of the reaction and of the blood sampling, the possible causal agents, and the treatment administered. These data must be shared with the laboratory and the allergist. An adverse drug reaction report must be filed. The gold standard for allergy assessment is skin testing. These tests should be done in an appropriate facility, with experienced staff and in compliance with current guidelines. Specific IgE assays and cellula...
Source: Presse Medicale - Category: Journals (General) Authors: Tags: Presse Med Source Type: research