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Updated: May 9, 2026

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The Patent Blue V Paradox: Hidden Offender, Serial Culprit.

Mariana Bragança1, Ana Luísa Pinhal1, Eunice Dias de Castro1

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PubMed
Summary

Patent Blue V (PBV) is a significant allergen causing hypersensitivity reactions during cancer surgery. Allergy diagnosis is effectively achieved through skin prick tests, indicating a rising incidence.

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Area of Science:

  • Allergy and Immunology
  • Surgical Oncology
  • Clinical Pathology

Background:

  • Patent Blue V (PBV) is widely used for sentinel lymph node identification in cancer surgery.
  • Its use is associated with an increased risk of hypersensitivity reactions.
  • Sentinel lymph node biopsy is a critical procedure in staging various cancers.

Purpose of the Study:

  • To investigate the incidence and characteristics of hypersensitivity reactions to Patent Blue V.
  • To evaluate diagnostic methods for PBV allergy.
  • To assess the trend of PBV allergy over time.

Main Methods:

  • Retrospective analysis of patients with suspected PBV hypersensitivity from 2010-2023.
  • Skin prick tests (SPT) and intradermal tests (IDT) were performed for diagnosis.
  • Analysis of patient demographics, reaction types, and timing of diagnostic tests.

Main Results:

  • Of 160 patients with perioperative hypersensitivity reactions (POH), 15 (9.4%) had received PBV.
  • PBV allergy was confirmed in 80% of cases via skin tests (SPT or IDT).
  • Anaphylaxis occurred in 58% of PBV-allergic patients, with a rising incidence observed.

Conclusions:

  • Patent Blue V is a significant allergen in the context of POH, with an increasing incidence.
  • Skin prick testing is an effective diagnostic tool for PBV allergy, suggesting an IgE-mediated mechanism.
  • Continued use of PBV is supported with appropriate precautions due to its clinical utility.