Anaphylactic Reactions to Native and Light-Exposed Sugammadex Suggested by Basophil Activation Test: A Report of 2 Cases

A A Pract. 2018 Oct 1;11(7):181-183. doi: 10.1213/XAA.0000000000000774.

Abstract

We describe 2 patients who developed anaphylactic shock after sugammadex administration during anesthesia. Both had no history of prior sugammadex administration. The serum tryptase concentrations were elevated after the allergic reaction. Basophil activation testing 1 month after the events was positive for sugammadex in 1 patient, and negative in the other. However, it was positive for light-exposed sugammadex solution in both patients, suggesting a possible allergic reaction to a denatured compound of sugammadex generated by light exposure of the sugammadex solution.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anaphylaxis / chemically induced
  • Anaphylaxis / drug therapy
  • Anaphylaxis / immunology*
  • Anesthesia / adverse effects
  • Basophils / cytology
  • Chlorpheniramine / administration & dosage
  • Chlorpheniramine / therapeutic use
  • Female
  • Humans
  • Light / adverse effects*
  • Male
  • Methylprednisolone / administration & dosage
  • Methylprednisolone / therapeutic use
  • Sugammadex / adverse effects*
  • Young Adult

Substances

  • Sugammadex
  • Chlorpheniramine
  • Methylprednisolone