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Blue Wheals and Blue Angioedema Induced by Blue Dyes: A Systematic Review
Kanokvalai Kulthanan1, Papapit Tuchinda1, Sasima Eimpunth1
1Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Summary
Blue dye injections can cause adverse reactions like blue wheals and angioedema, sometimes leading to anaphylaxis. Prompt treatment with antihistamines, corticosteroids, and epinephrine is effective for these reactions.
Area of Science:
- Medical Diagnostics
- Allergology
- Pharmacovigilance
Background:
- Adverse reactions to blue dye injections, including blue wheals and angioedema, are not well-defined.
- These reactions can occur with or without anaphylaxis.
Purpose of the Study:
- To review the characteristics of blue dye adverse reactions.
- To analyze clinical manifestations, natural courses, and treatments of these reactions.
Main Methods:
- Systematic review of articles published up to July 2021.
- Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
Main Results:
- Out of 523 patients, 36.9% experienced wheals or angioedema after blue dye injection.
- Patent blue violet showed the highest association with blue wheals/angioedema (OR 4.9).
- Systemic symptoms preceded anaphylaxis in nearly all affected patients; antihistamines, corticosteroids, and epinephrine were effective treatments.
Conclusions:
- Blue dye administration can result in blue wheals, angioedema, and systemic reactions.
- Repeat blue dye administration in patients with a history of severe allergic reactions requires careful risk-benefit assessment.
Keywords:
Blue angioedemaBlue dyesBlue whealsClinical featuresCross-reactionOutcomesSystematic reviewTreatment
