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Intraoperative Anaphylaxis Following Injection of a Bleomycin-Gelatin Solution for Sclerotherapy
Laura Roberts1, Leah Braswell2, Gregory Maves3,4
1Heritage College of Osteopathic Medicine - Dublin Campus, Dublin, Ohio and Ohio University, Athens, OH, USA.
Journal of Medical Cases
|April 25, 2022
Summary
Gelatin in Surgiflo®, used with bleomycin for vascular malformations, can cause perioperative anaphylaxis. This case highlights the need to consider all agents, including sclerosants, in allergic reactions.
Area of Science:
- Anesthesiology
- Dermatology
- Vascular Surgery
Background:
- Perioperative allergic reactions are common, with antibiotics, neuromuscular blockers, and opioids as frequent culprits.
- Sclerotherapy for vascular malformations often uses bleomycin, sometimes combined with agents like Surgiflo® to enhance efficacy.
- Surgiflo® contains gelatin derived from animal collagen, a potential allergen.
Observation:
- An 11-year-old girl experienced perioperative hemodynamic instability after receiving bleomycin and Surgiflo® for a venous malformation.
- The patient's reaction occurred during sclerotherapy, necessitating medical intervention.
Findings:
- Allergic reaction was attributed to gelatin in Surgiflo®, not bleomycin.
- This case underscores the importance of considering all injected substances, including sclerosants, in perioperative anaphylaxis evaluations.
Implications:
- Healthcare providers must consider gelatin-containing sclerosants as potential allergens in patients undergoing sclerotherapy.
- Awareness of this risk can improve perioperative management and treatment of anaphylaxis in such cases.
- Further investigation into the immunogenicity of collagen-derived products used in medical procedures is warranted.
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