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A Parashchanka1, P A H Wyffels, J G M Van Limmen

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Acta Anaesthesiologica Belgica
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Anaphylactic shock can transiently cause hyperfibrinolysis, a condition of excessive blood clot breakdown. Thromboelastography (TEG) diagnosed this short-lived issue in a patient, highlighting a rare association.

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Area of Science:

  • Anesthesiology
  • Hematology
  • Critical Care Medicine

Background:

  • Anaphylactic shock is a severe, life-threatening allergic reaction.
  • Hyperfibrinolysis, characterized by excessive breakdown of blood clots, is a less common complication.
  • Thromboelastography (TEG) is a viscoelastic assay used to assess hemostasis.

Observation:

  • A 45-year-old female patient experienced anaphylactic shock during induction for vacuum-assisted wound closure.
  • Initial TEG analysis revealed significant hyperfibrinolysis despite clinical stability post-treatment.
  • No spontaneous bleeding was observed, and surgery was postponed.

Findings:

  • TEG demonstrated transient hyperfibrinolysis associated with anaphylactic shock.
  • A repeat TEG 30 minutes later showed a normalized coagulation profile.
  • This case highlights the temporary nature of hyperfibrinolysis in this context.

Implications:

  • The findings suggest a potential, transient hemostatic derangement during anaphylactic shock.
  • Early diagnosis of hyperfibrinolysis using TEG may guide clinical management.
  • Further research is needed to elucidate the mechanisms and clinical significance of this association.