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Perioperative anaphylaxis in a patient with a solitary mastocytoma

Sheila Requena López1, Almudena Matito2, Iván Alvarez-Twose2

  • 1Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.

Pediatric Dermatology
|March 12, 2019
PubMed

Insights

Children with cutaneous mastocytosis, even with a solitary lesion, face anaphylaxis risk during surgery. Careful anesthetic management is crucial for these pediatric patients to prevent severe reactions.

Area of Science:

  • Pediatric Allergy and Immunology
  • Dermatology
  • Anesthesiology

Background:

  • Cutaneous mastocytosis (CM) involves abnormal mast cell accumulation in the skin.
  • Extensive CM correlates with systemic symptoms due to mast cell mediator release.
  • Anaphylaxis risk in CM, even with solitary lesions, necessitates careful consideration for surgical procedures.

Observation:

  • A pediatric patient with a solitary mastocytoma experienced anaphylaxis during surgery.
  • This case highlights the potential for severe allergic reactions in seemingly low-risk CM patients.
  • Intraoperative anaphylaxis can occur unexpectedly in children with mast cell disease.

Findings:

  • Solitary mastocytoma can be associated with a risk of anaphylaxis during general anesthesia.
  • Mast cell mediator release can trigger severe systemic reactions even from localized skin lesions.
  • Proactive anesthetic management strategies are essential for patients with mast cell disease.

Implications:

  • Clinicians should exercise caution when administering general anesthesia to children with any form of mastocytosis.
  • Preoperative assessment and planning are vital to mitigate anaphylaxis risk in pediatric surgical patients with mast cell disease.
  • Recommendations are provided to minimize intraoperative anaphylaxis in children with mast cell disease.

Keywords:
anaphylaxissolitary mastocytoma

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