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[Anaphylactic shock caused by fibrin glue]
I Orsel1, A Guillaume, P Feiss
1Département d'anesthésie-réanimation, CHU Dupuytren, Limoges, France.
Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1997
Summary
Anaphylactic shock occurred in a patient after nasal fibrin glue injection. Allergy to aprotinin, a component of the glue, was identified as the cause.
Area of Science:
- Otolaryngology
- Allergy and Immunology
- Dermatology
Background:
- Fibrin glue is utilized in various medical procedures, including nasal surgeries and treatments.
- Telangiectasias are abnormal, small blood vessels that can appear on the face and nose.
- Aprotinin is a proteinase inhibitor sometimes included in biological glues.
Observation:
- A 68-year-old female experienced anaphylactic shock following an intranasal intramucosal injection of fibrin glue.
- The fibrin glue was administered for the treatment of nasal telangiectasias.
- The patient had a history of receiving fibrin glue and aprotinin for nasal bleeding in prior years.
Findings:
- Diagnostic tests confirmed the patient's allergy to aprotinin.
- Aprotinin, present in the fibrin glue, was identified as the causative agent of the anaphylactic reaction.
- Prior repeated exposure to aprotinin may have led to sensitization.
Implications:
- This case highlights the potential for anaphylaxis due to aprotinin in fibrin glue, even after repeated previous administrations.
- Clinicians should consider aprotinin allergy in patients presenting with anaphylaxis post-fibrin glue application.
- Further investigation into the immunogenicity of fibrin glue components may be warranted.