Fatal Anaphylactic Shock Induced by Intravenous Gelatin Colloid: A Postmortem Allergological Work-up

摘要

Hypersensitivity reactions (HRs) during perioperative procedures have an estimated prevalence of 1:10 000 to 1:20 000 cases [1]. In previous studies, neuromuscular blocking agents (NMBAs) were the most frequent cause of perioperative HRs in countries such as France, Norway, and Belgium, as were ?-lactam antibiotics in the United States [1,2]. Studies in Spain and the United Kingdom also showed that ?-lactam antibiotics were the main culprit of perioperative HRs [3,4]. Colloid solutions are a less frequent cause of severe perioperative HRs, involving up to 4% of cases [2]. However, recent data showed that the rate of anaphylaxis per administration was equal to that of the most frequently involved NMBA, rocuronium, at 6.2 per 100 000 administrations in the United Kingdom [5,6].