Indolent systemic mastocytosis manifesting as protracted anaphylactic shock

Manidipam Chatterjee, Saikat Sengupta, Chandrashish Chakravarty, Suresh Ramasubban, Shilpa Bhartia, Sujoy Khan, Vikash Kumar AgarwalIndian Journal of Critical Care Medicine 2018 22(4):311-313Systemic mastocytosis is a rare disease due to abnormal proliferation of mast cells (MCs). A case of indolent systemic mastocytosis is presented here. After anesthetic induction for elective thyroid swelling with propofol and atracurium followed by endotracheal intubation, a 57-year-old female patient developed acute hypotension, sinus tachycardia, red rashes, increased airway pressure along with difficult ventilation, and desaturation. She developed multiorgan failure subsequently. MC tryptase level was persistently high. Bone marrow study revealed mastocytosis. She required antihistaminic, steroid, and organ support. With treatment, organ functions recovered gradually. Atracurium precipitated anaphylactic shock causing severe morbidity in this patient.

Source: Indian Journal of Critical Care Medicine - April 18, 2018 Category: Intensive Care Authors: Manidipam Chatterjee Saikat Sengupta Chandrashish Chakravarty Suresh Ramasubban Shilpa Bhartia Sujoy Khan Vikash Kumar Agarwal Source Type: research