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Updated: Oct 8, 2025

Measuring Local Anaphylaxis in Mice
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Isosulfan Blue and Anaphylaxis.

Abin Sajan1,2, Daniel W Griepp1,3, Hazim Hakmi1

  • 1Department of Surgery, NYU Langone Hospital-Long Island, Mineola, NY.

Ochsner Journal
|January 5, 2022
PubMed
Summary
This summary is machine-generated.

Allergic reactions to Isosulfan blue dye (Lymphazurin) during breast cancer surgery can be severe, requiring intensive care. While severe anaphylaxis is reported, milder reactions are likely underdiagnosed, posing risks to patients.

Keywords:
Anaphylaxiscontrastisosulfan blue

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Area of Science:

  • Oncology
  • Anesthesiology
  • Allergy and Immunology

Background:

  • Isosulfan blue dye (Lymphazurin) is a common agent for sentinel lymph node biopsy in breast cancer surgery.
  • Reported allergic reactions to Lymphazurin range from mild dermatologic responses to severe anaphylaxis.

Observation:

  • This case series details two patients experiencing grade 3 anaphylaxis to Lymphazurin, necessitating vasopressors and intensive monitoring.
  • A literature review identified 108 additional patients with confirmed Lymphazurin allergic reactions.

Findings:

  • The majority of reported reactions were grade 3 (51.8%), followed by grade 1 (36.4%) and grade 2 (11.8%).
  • Among patients with reported hospital courses, 23 required surgical intensive care unit admission.
  • Surgery was canceled in 46.1% of cases due to Lymphazurin-induced reactions.

Implications:

  • Severe anaphylactic reactions to Lymphazurin pose significant risks during breast cancer surgery.
  • Mild reactions are likely underreported, highlighting the need for increased awareness.
  • Operating room personnel must be trained to recognize and promptly treat Lymphazurin allergic reactions.