A Case of Intraoperative Anaphylaxis Caused by Bovine-Derived Thrombin.
10.4168/aair.2018.10.2.184
- Author:
Hye Jung PARK
1
;
Kyung Soo SUK
;
Jung Won PARK
Author Information
1. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. craft7820@yuhs.ac
- Publication Type:Case Report
- Keywords:
Anaphylaxis;
bovine;
thrombin
- MeSH:
Adult;
Anaphylaxis*;
Angioedema;
Blood Pressure;
Exanthema;
Female;
Gelatin Sponge, Absorbable;
Hemostasis;
Humans;
Immunoglobulin E;
Immunoglobulins;
Intervertebral Disc Displacement;
Orthopedics;
Red Meat;
Skin Tests;
Spinal Cord Diseases;
Thrombin*;
Urticaria
- From:Allergy, Asthma & Immunology Research
2018;10(2):184-186
- CountryRepublic of Korea
- Language:English
-
Abstract:
Intraoperative bovine-derived topical thrombin is still widely used for hemostasis during surgery. A 38-year-old woman with chronic spontaneous urticaria was referred to the orthopedic surgery department for herniated disk and myelopathy. During the first stage of operation, bovine-derived thrombin powder soaked in Gelfoam was used as a hemostatic aid. After 30 minutes, the patient developed anaphylactic shock with systemic skin rash and angioedema. Repeated intravenous bolus and infusion of vasopressor were carried out, and her blood pressure normalized. Skin test and specific immunoglobulin E test showed positive results for bovine thrombin and beef, respectively. During the second stage of operation (After 10 days from first stage of operation), bovine-derived thrombin powder was excluded and the operation was successful without any unexpected events. Therefore, bovine thrombin should be used with caution because it might cause anaphylaxis.
