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Anaphylactic reaction with hydroxyethyl starch during anesthesia - A case report
Gunnhee Kim1, Goeun Kim1, Miyoung Kwon1
1Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea.
Hydroxyethyl starch (HES) can cause allergic reactions, including anaphylaxis, even in patients without prior allergy history. Prompt medical intervention and diagnostic tests like serum tryptase are crucial for managing HES-induced hypersensitivity.
Area of Science:
- Anesthesiology
- Pharmacology
- Immunology
Background:
- Hydroxyethyl starch (HES) is a synthetic colloid solution frequently used for perioperative hypovolemia.
- Despite its widespread use, HES administration carries a risk of hypersensitivity reactions.
Observation:
- An 83-year-old male patient developed hypotension, agitation, and rash minutes after HES infusion during surgery.
- The patient had no documented history of allergies.
- Vital signs improved after treatment with phenylephrine, dexamethasone, and hydrocortisone.
Findings:
- The patient experienced a suspected anaphylactic reaction to HES.
- Elevated serum tryptase and total immunoglobulin E levels confirmed the allergic reaction.
- Diagnosis was supported by laboratory markers of hypersensitivity.
Implications:
- Highlights the potential for severe allergic reactions to HES, even in naive patients.
- Emphasizes the importance of recognizing anaphylaxis symptoms during HES administration.
- Underscores the utility of specific laboratory tests in diagnosing HES-induced hypersensitivity.
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