Elevated Serum Tryptase Level in a Case of Intraoperative Anaphylaxis Caused by Latex Allergy

Abstract

We measured serial serum tryptase levels in a case of intraoperative anaphylaxis caused by allergy to latex. The serum tryptase level was elevated 7 hours after the hypotensive episode and returned to normal after recovery 4 months later. Both skin tests to latex and serum IgE to latex confirmed latex allergy in this patient. To our knowledge, this is the first report of an elevated serum tryptase level in intraoperative anaphylaxis caused by latex allergy. This observation confirms the role of mast cell degranulation in anaphylaxis caused by allergy to latex.

Latex Allergy during Anaesthesia: Cautionary Tales

“…The surgeons who operated on these two women wore latex gloves and the patients were exposed to latex components on several other items of equipment. The positive prick tests 3 and elevated mast cell tryptase levels 4 suggest an IgEmediated reaction. When interrogated by their anaesthetist preoperatively, and at the time of skin testing both denied any allergies but later gave a clear-cut history of allergy to latex on specific questioning.…”

“…Allergy to latex is increasing, and becoming a serious problem in many countries 1 particularly in healthworkers 1 and patients with spina bifida 2,3 . Anaphylaxis to latex has been described during anaesthesia, and characteristically produces a delayed reaction not temporally related to drug administration [3][4][5][6][7] .…”

Serum Tryptase Measurement in Diagnosis of Intraoperative Anaphylaxis Caused by Hydatid Cyst

“…A sudden appearance of hypotension, tachycardia, or bronchospasm coincidental with surgical handling should alert the anaesthetist. In spite of a high index of suspicion of anaphylactic reaction by hydatid disease in a mechanically ventilated patient, other pathologies such as cardiac failure, drug or latex anaphylaxis [10][11][12] , hypovolaemia, pulmonary thromboembolism and tension pneumothorax have to be excluded. Our patient showed ECG abnormalities secondary to hypotension, but neither bleeding nor ventilatory disturbances were observed.…”