Anaphylaxis to dyes during the perioperative period: Reports of 14 clinical cases

Mertès, Paul-Michel; Malinovsky, J. M.; Mouton‐Faivre, C.; Bonnet-Boyer, M.-C.; Benhaijoub, Abdelhaouad; Lavaud, F.; Valfrey, J.; O’Brien, James P.; Pirat, Philippe; Lalourcey, Laurent; Demoly, Pascal

doi:10.1016/j.jaci.2008.04.040

Cited by 102 publications

(85 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nowadays, reactions to vital dyes are being more frequently reported due to its increased use in lymphatic mappings and in sentinel lymph node biopsies in patients with breast cancer and other malignancies 12,15 . Cases and meta-analysis of anaphylactic reactions are described due to the use of blue dyes in sentinel lymph node identification.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hemosiderin: a new marker for sentinel lymph node identification

Pinheiro¹,

Filho

Vasques

et al. 2009

Acta Cir. Bras.

View full text Add to dashboard Cite

Purpose:To evaluate and present our initial results of a new marker (hemosiderin) for mammary sentinel lymph node identification in an experimental model. Methods: Skins mapped like a lymphatic duct draining to the axilla in patients submitted to breast biopsy, in our mastology service, stimulated us to try it in an animal model (female dogs). Our theory was that some blood derivate (hemosiderin) was captured by macrophages and accessed the lymphatic ducts in direction to the axilla. Six female dogs of no defined race were studied. We injected 0,2 ml of technetium on both superior mammary glands. After ten minutes, a 2,5 ml solution of hemolized blood (hemosiderin) from the own animal was injected in the subareolar lymphatic plexus on the left superior mammary gland and 2,5 ml of patent blue concomitantly and equally on the contralateral gland. Ten minutes after, incisions on both axilas were made to search, through the lymphatic mapping and a gamma probe, the sentinel lymph nodes. Results: Seven brown sentinel lymph nodes were indentified and also radiomarked on the left axilla. Six blue sentinel lymph nodes were identified and also radiomarked on the right axilla. Conclusion: Preliminary studies of a potential new dye for sentinel lymph node identification are presented. It may be the change of the current use of the blue dyes and their severe side-effects on patients submitted to sentinel lymph node biopsies. Key words: Breast Neoplasms. Sentinel Lymph Node Biopsy. Hemosiderin. RESUMOObjetivo: Avaliar e apresentar resultados preliminares de um novo marcador (hemossiderina) para a identificação de linfonodos sentinela mamários em um modelo experimental. Métodos: Durante acompanhamento de dois casos de biópsias excisionais de tumores da mama, no nosso serviço de mastologia, observou-se trajeto pigmentado no quadrante inferior externo daquelas mamas, sugerindo ser marcação cutânea do ducto de drenagem linfática a partir da papila mamária em direção a axila homolateral. Levantamos a hipótese que um derivado sanguíneo (hemossiderina) foi capturado por macrófagos obtendo acesso aos ductos linfáticos em direção à axila. Seis cadelas sem raça definida foram estudadas. Injeção de 0,2 ml de tecnécio foi realizada em ambas as mamas superiores. Após 10 minutos, uma solução de 2,5 ml de sangue hemolizado (hemossiderina) do próprio animal foi injetado no plexo linfático subpapilar da mama esquerda e 2,5 ml de azul patente na mama contralateral concomitantemente e igualmente. Após mais 10 minutos, incisões axilares foram realizadas para a procura, pela coloração e com um gama probe, dos linfonodos sentinela. Resultados: Sete linfonodos sentinela castanhos e radiomarcados foram identificados na axila esquerda. Seis linfonodos sentinela azuis e radiomarcados foram identificados na axila direita. Conclusão: São apresentados estudos preliminares de um potencial novo marcador para identificação do linfonodo sentinela. Este poderá mudar o uso dos corantes vitais e de seus efeitos adversos em pacientes submetidos à biópsi...

show abstract

Section: Discussionmentioning

confidence: 99%

“…One of these is the vital blue dye use for the lymphatic mapping which may cause severe hypersensitivity reactions on patients 12 .…”

Section: Introductionmentioning

confidence: 99%

Hemosiderin: a new marker for sentinel lymph node identification

Pinheiro¹,

Filho

Vasques

et al. 2009

Acta Cir. Bras.

View full text Add to dashboard Cite

show abstract

“…These reactions are possibly associated with IgE actions, but the mechanisms underlying the allergic reaction to patent Blue remain unclear (Mertes et al 2008, Hunting et al 2010.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of physiological parameters of dogs submitted to uterine lymphatic mapping using patent blue V dye for anaphylaxis detection

et al. 2016

View full text Add to dashboard Cite

RESUMO.-[Avaliação de parâmetros fisiológicos de cães submetidos ao mapeamento linfático uterino usando o corante azul patente V para a detecção de anafilaxia.] O mapeamento linfático tem sido realizado em humanos e cães. Embora inúmeros casos de anafilaxia já tenham sido relatados em humanos, não existem tais relatos em cães. O objetivo deste estudo foi identificar a ocorrência de reações adversas ao corante azul patente V em cadelas submetidas ao mapeamento linfático uterino, usando avaliações cardiovasculares e hematológicas. O experimento foi realizado em 14 cadelas mestiças, divididas igualmente em dois grupos (PBV-mapeamento linfático uterino e OEH; Controle -apenas OEH). Os animais foram submetidos a exames hematológicos e bioquímicos séricos no pré e pós-operató-rio (7 dias). O protocolo anestésico foi: sedação (morfina e acepromazina), indução (propofol), manutenção (isoflurano), analgesia trans-operatória (fentanil Lymphatic mapping has been performed in humans and dogs. Although several cases of anaphylaxis have been reported in humans, there are no such reports in dogs. The objective of this study was to identify the occurrence of adverse reactions to patent blue V dye in bitches undergoing uterine lymphatic mapping procedures using cardiovascular and hematological evaluations. The experiment was performed in 14 mongrel bitches without any reproductive disease, randomly assigned into two equal groups (PBV-uterine lynphatic mapping and OHE; Control -OHE only). The animals were submitted to pre-and postoperative hematological and serum biochemistry exams (7 days). The anesthetic protocol was: sedation (morphine and acepromazine), induction (propofol), maintenance (isoflurane), transoperative analgesia (fentanyl). Systolic blood pressure was monitored throughout the procedure and arterial blood gas analysis was performed immediate pre and postoperatively. For lymphatic mapping was injected patent blue V in the uterine wall, 10 minutes before OEH. Comparisons between the pre-and postoperative parameters within the same animal were performed using the Wilcoxon-Mann-Whitney test. To compare the values between control and PBV group was obtaining the difference between the pre and post of each group, subjected to the Mann-Whitney test (significance of 5%). Differences were observed (P<0.05) between the pre-and postoperative evaluations in the PBV (total protein and the albumin serum), in both groups (arterial partial pressure of oxygen) and in the Control (arterial oxygen saturation). There were no signs of adverse reactions to the patent blue V dye in the healthy bitches submitted to lymphatic uterine mapping.INDEX TERMS: Uterine lymphatic mapping, patent blue V dye, anaphylaxis, hypersensitivity, bitches, vital dye.

show abstract

“…Other dyes can also be used in SLN identification during the surgical procedure, such as methylene blue, patent blue, and isosulfan blue 8 however, such substances -in a recent literature review -revealed a significant number of hypersensitivity reactions 9,10 . Patent blue dye can cause from subtle adverse effects, such as skin rash, to severe reactions of anaphylaxis 11,12 .…”

Section: Introductionmentioning

confidence: 99%

Comparison between hemosiderin and Technetium-99 in sentinel lymph node biopsy in human breast cancer

Vasques

Alves²,

Aquino³

et al. 2015

Acta Cir. Bras.

View full text Add to dashboard Cite

. Intellectual, scientific, conception and design of the study. ABSTRACT PURPOSE:To assess the safety and potential equivalence of the use of hemosiderin compared to the Technetium-99 in sentinel lymph node biopsy in human breast cancer. METHODS:Non-random sample of 14 volunteer women diagnosed with breast cancer with primary tumors (T1/T2) and clinically tumor-free axilla were submitted to the identification of sentinel lymph node using hemosiderin obtained from autologous blood injected in the periareolar region 24h before surgery on an outpatient basis. Patients received preoperative subareolar intradermal injection of Technetium-99 in the immediate preoperative period. Patients were submitted to sentinel lymph node biopsy, with incision in the axillary fold guided by Gamma-Probe, dissection by planes until the identification of the point of maximum uptake of Technetium-99, identifying the marked nodes and their colors. All surgical specimens were sent for pathological and immunohistochemical study. RESULTS:The results showed no evidence of side effects and/or allergic and non-allergic reactions in patients submitted to SLNB with hemosiderin. The SLN identification rate per patient was 100%. SLNB identification rate per patient with hemosiderin was the same as that of Technetium, with a concordance rate of 100% between the methods. CONCLUSION:Hemosiderin is a safe dye that is equivalent to Technetium in breast sentinel lymph node biopsy.

show abstract

Anaphylaxis to dyes during the perioperative period: Reports of 14 clinical cases

Cited by 102 publications

References 39 publications

Hemosiderin: a new marker for sentinel lymph node identification

Hemosiderin: a new marker for sentinel lymph node identification

Evaluation of physiological parameters of dogs submitted to uterine lymphatic mapping using patent blue V dye for anaphylaxis detection

Comparison between hemosiderin and Technetium-99 in sentinel lymph node biopsy in human breast cancer

Contact Info

Product

Resources

About