Fluorescein-induced allergic reaction
Fluorescein-induced allergic reaction
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DOI：
10.1016/s1081-1206(10)63140-7
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发表时间：
1998-11-01
影响因子：
5.9
通讯作者：
Baeza, ML
中科院分区：
文献类型：
--
作者：
López-Sáez, MP;Ordoqui, E;Baeza, ML
背景：静脉注射荧光素钠引起的不良反应非常罕见，其机制尚不清楚。我们报告一例患者在荧光素眼底血管造影术中出现不良反应。目的：报道1例静脉注射荧光素时发生不良反应的患者的过敏反应。方法：我们选择了1例患者，在荧光素眼部血管造影中出现头晕、出汗、面色苍白、恶心、括约肌松弛、低血压和严重不适，并将结果与其他无反应的受试者进行比较。过敏反应评估：对接受相同程序的患者和4名对照组以及1名在采血过程中出现强烈迷走神经反应的患者进行了皮试和皮内试验，并进行了血清类胰蛋白酶的系列测定。结果：我们的患者皮试阳性，血清类胰蛋白酶(67U/I)显著升高。其余患者皮试呈阴性，血清类胰酶无任何变化。结论：IgE介导的机制可能是导致这种不良反应的原因。我们建议对所有对荧光素有不良反应的患者进行全面的过敏评估，以便将真正的过敏反应与其他类型的反应区分开来。
Background: Adverse reactions following intravenous sodium fluorescein are very unusual and their mechanism is still uncertain. We report the case of a patient who suffered an adverse reaction during a fluorescein ocular angiography. Positive allergy tests to fluorescein suggest an IgE-mediated mechanism.Objective: Report the allergy evaluation performed in a patient who suffered an adverse reaction during an intravenous fluorescein administration.Methods: We selected the case of a patient who suffered dizziness, diaphoresis, generalized pallor, nausea, sphincter relaxation, hypotension, and intense malasie during a fluorescein ocular angiography and compared the results to other nonreactive subjects. Allergy evaluation: Prick and intradermal skin tests and serial determinations of serum tryptase were performed on the patient and four control subjects who underwent and tolerated the same procedure as well as on a patient who developed an intense vagal reaction during blood extraction.Results: Positive skin tests and dramatic increase of serum tryptase (67U/I) were observed in our patient. The rest of the patients had negative skin tests and did not have any variation in their serum tryptase.Conclusions: An IgE-mediated mechanism is suggested as responsible for this adverse reaction. We recommend that a complete allergy evaluation should be performed in all patients who have adverse reactions to fluorescein in order to differentiate true allergic reactions from other types of reactions.