Anaphylaxis induced by sugammadex and sugammadex-rocuronium complex -a case report.

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  • Author(s): Choi SC;Choi SC; Han S; Han S; Kwak J; Kwak J; Lee JY; Lee JY
  • Source:
    Korean journal of anesthesiology [Korean J Anesthesiol] 2020 Aug; Vol. 73 (4), pp. 342-346. Date of Electronic Publication: 2019 Oct 17.
  • Publication Type:
    Case Reports
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Korean Society of Anesthesiologists Country of Publication: Korea (South) NLM ID: 101502451 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2005-7563 (Electronic) Linking ISSN: 20056419 NLM ISO Abbreviation: Korean J Anesthesiol Subsets: MEDLINE
    • Publication Information:
      Original Publication: Seoul : Korean Society of Anesthesiologists
    • Subject Terms:
      Anaphylaxis/*chemically induced ; Intraoperative Complications/*chemically induced ; Neuromuscular Nondepolarizing Agents/*adverse effects ; Rocuronium/*adverse effects ; Sugammadex/*adverse effects; Anaphylaxis/diagnosis ; Anaphylaxis/physiopathology ; Drug Combinations ; Humans ; Intraoperative Complications/diagnosis ; Intraoperative Complications/physiopathology ; Male ; Middle Aged ; Neuromuscular Nondepolarizing Agents/administration & dosage ; Rocuronium/administration & dosage ; Sugammadex/administration & dosage
    • Abstract:
      Background: In sugammadex-induced anaphylaxis, sugammadex and/or sugammadex-rocuronium complex have possible allergenic epitope.
      Case: We report a case of sugammadex-induced anaphylaxis during general anesthesia in a 60-year-old male undergoing orthopedic hand surgery, manifesting as profound hypotension and urticaria. The timing of onset was closely associated with sugammadex administration. The patient recovered after extensive therapy including fluid, epinephrine, other vasopressors, steroid, and antihistamine administration. By intradermal skin test which was done at four weeks after anaphylaxis, we confirmed positive reactions to both sugammadex and sugammadex-rocuronium complex.
      Conclusions: This is a rare case of sugammadex-induced anaphylaxis that both sugammadex and sugammadex-rocuronium complex were confirmed as allergenic epitopes.
    • References:
      Br J Anaesth. 2018 Oct;121(4):758-767. (PMID: 30236238)
      J Allergy Clin Immunol Pract. 2017 May - Jun;5(3):587-592. (PMID: 28483312)
      J Anesth. 2016 Apr;30(2):290-7. (PMID: 26646837)
      J Asthma Allergy. 2018 Jun 20;11:121-142. (PMID: 29950872)
      Clin Exp Immunol. 2014 Nov;178(2):399-404. (PMID: 25070464)
      A A Case Rep. 2016 Nov 1;7(9):190-192. (PMID: 27552242)
      Anesth Analg. 2018 May;126(5):1505-1508. (PMID: 29064876)
      Korean J Anesthesiol. 2016 Aug;69(4):413-6. (PMID: 27482323)
      Allergol Int. 2016 Jul;65(3):356-8. (PMID: 27062217)
      Br J Anaesth. 2018 Oct;121(4):749-757. (PMID: 30236237)
      Anaesth Intensive Care. 2014 Jan;42(1):93-6. (PMID: 24471669)
      Anaesth Intensive Care. 2016 Jan;44(1):122-4. (PMID: 26673602)
      J Clin Anesth. 2018 Aug;48:7. (PMID: 29660702)
      Anaesthesia. 2014 Nov;69(11):1251-7. (PMID: 24848211)
      BMJ Case Rep. 2017 May 13;2017:. (PMID: 28501827)
    • Contributed Indexing:
      Keywords: Anaphylaxis; General anesthesia; Hypotension; Rocuronium; Skin test; Sugammadex; Urticaria
    • Accession Number:
      0 (Drug Combinations)
      0 (Neuromuscular Nondepolarizing Agents)
      361LPM2T56 (Sugammadex)
      WRE554RFEZ (Rocuronium)
    • Publication Date:
      Date Created: 20191018 Date Completed: 20210716 Latest Revision: 20210716
    • Publication Date:
      20221213
    • Accession Number:
      PMC7403119
    • Accession Number:
      10.4097/kja.19344
    • Accession Number:
      31619026