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The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
Published on: June 1, 2019
Biphasic anaphylactic reaction to blue dye during sentinel lymph node biopsy
Margaret I Liang1, William E Carson
1Division of Surgical Oncology, The Ohio State University, Columbus, OH, USA. Margaret.Liang@osumc.edu
World Journal of Surgical Oncology
|July 29, 2008
Summary
Lymphazurin 1% blue dye can cause anaphylaxis. A biphasic reaction occurred in a patient undergoing mastectomy, requiring prolonged monitoring and aggressive management for delayed hypotension.
Area of Science:
- Anesthesiology
- Surgical Oncology
- Allergy and Immunology
Background:
- Lymphazurin 1% blue dye is used for sentinel lymph node biopsy.
- It carries a 1-3% risk of severe anaphylactic reactions.
Observation:
- A 48-year-old woman experienced intraoperative anaphylaxis after Lymphazurin 1% injection during mastectomy.
- She presented with biphasic anaphylaxis, including two hypotensive episodes at 15 minutes and 2 hours post-injection.
- The late-phase reaction was refractory to epinephrine treatment.
Findings:
- Intraoperative anaphylaxis from Lymphazurin 1% can manifest as a biphasic reaction.
- Delayed hypotension is a key feature of biphasic anaphylaxis.
- Refractory hypotension may necessitate advanced hemodynamic support.
Implications:
- Clinicians must be vigilant for anaphylaxis during procedures using Lymphazurin 1%.
- Aggressive hemodynamic management and prolonged monitoring are crucial for biphasic reactions.
- Early recognition and intervention can improve patient outcomes in dye-induced anaphylaxis.
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