Anaphylaxis to dyes during the perioperative period: reports of 14 clinical cases

Paul Michel Mertes ¹, Jean Marc Malinovsky , Claudie Mouton-Faivre

⁰Service d'Anesthésie-Réanimation, Hôpital Central, Centre Hospitalier Universitaire de Nancy, Nancy, France. pm.mertes@chu-nancy.fr

The Journal of Allergy and Clinical Immunology +

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June 17, 2008

View abstract on PubMed

Summary

Anaphylactic reactions to Patent Blue dye used in lymphatic mapping are increasingly reported. These hypersensitivity reactions are often severe, delayed, and prolonged, requiring intensive care.

Area Of Science

Anesthesiology
Allergy and Immunology
Oncology

Background

Vital dyes are crucial for lymphatic mapping and sentinel lymph node biopsy in cancer patients.
Anaphylactic reactions to these dyes are a growing concern.

Purpose Of The Study

To detail the clinical presentation of hypersensitivity reactions to Patent Blue.
To report allergy workup findings and management outcomes.

Main Methods

A retrospective case series of 14 patients experiencing dye-induced anaphylaxis.
Data collected from four French allergoanesthesia centers between 2004 and 2006.

Main Results

Reactions were often severe (6/14 Grade III) and delayed (average 30 min onset).
Many reactions were prolonged (9/14), necessitating intensive care.
Allergy testing showed positive prick tests in 8/14 and positive intradermal tests in 5/9 patients with negative prick tests.

Conclusions

Anesthesiologists and allergologists must recognize the risk of Patent Blue-induced anaphylaxis.
Key features include delayed onset and prolonged duration, requiring specific awareness and management strategies.

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