Un cas de choc anaphylactique à l'acide tranexamique (Exacyl®)

Lucas-Polomeni, Marie-Madeleine; Delaval, Y; Ménestret, P; Delaval, P; Ecoffey, Claude

doi:10.1016/j.annfar.2004.04.012

Cited by 41 publications

(26 citation statements)

References 4 publications

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“…Our patient and her reaction have several similarities to the only other detailed report on TXA anaphylaxis [4]. In both cases anaphylactic reactivity occurred in elderly patients without previous atopy.…”

Section: Discussionsupporting

confidence: 79%

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Tranexamic Acid: An Exceedingly Rare Cause of Anaphylaxis during Anaesthesia

Bansal

Nicholas

Bansal

2016

Case Reports in Immunology

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Tranexamic acid (TXA) allergy is extremely rare. An 80-year-old woman without prior exposure to TXA underwent elective knee replacement. Shortly after induction of anaesthesia and intravenous TXA, she developed hypotension, tachycardia, and facial erythema accompanied by a raised serum tryptase. Later, skin prick and intradermal testing confirmed positive responses to TXA in high dilution and with negative results to the other drugs used. While neuromuscular blocking agents, opiates, and antibiotics remain the most frequent cause of anaphylaxis during anaesthesia, allergy to TXA should always be borne in mind and requires skin testing for confirmation as there are presently no blood tests available.

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Section: Discussionsupporting

confidence: 79%

“…This is only the second time that this has been reported [4], but it should nevertheless be considered as a cause of cardiorespiratory distress during induction of anaesthesia (IOA). Informed consent was granted by the patient for her clinical details to be shared in this case report.…”

Section: Introductionmentioning

confidence: 99%

Tranexamic Acid: An Exceedingly Rare Cause of Anaphylaxis during Anaesthesia

Bansal

Nicholas

Bansal

2016

Case Reports in Immunology

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“…Although the intravenous form has been shown to be safe and effective, there is a real risk of anaphylactic shock17). So far, the allergic reactions reported for the oral form were milder and slower onset29,30).…”

Section: Discussionmentioning

confidence: 99%

“…Both forms were shown to be equally effective13,14). While TXA is very safe to use with no evident increase in mortality or life threatening thromboembolic events4,15,16), drug allergy with anaphylactic shock has been reported with the intravenous form17). The topical form carries the theoretical risk of periprosthetic infection due to needle contamination and may aggravate sepsis18).…”

Section: Introductionmentioning

confidence: 99%

Blood Sparing Efficacy of Oral Tranexamic Acid in Primary Total Knee Arthroplasty: A Randomized Controlled Trial

Lee¹,

Ching²,

Wong³

2017

Knee Surg Relat Res

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PurposeTranexamic acid (TXA) is effective in reducing blood loss in primary total knee replacement. Almost all studies used an intravenous form or a topical form. The aim of this study was to assess the blood sparing efficacy and the safety of oral TXA.Materials and MethodsAll patients with primary total knee replacement performed in our institute from January 2015 to October 2015 were eligible. Oral TXA group was given 1 g oral TXA 2 hours before induction of anesthesia and 6 hours and 12 hours postoperatively. The control group was not given TXA.ResultsThere were 94 cases in the oral TXA group and 95 cases in the control group. There was no difference in the baseline characteristics. The oral TXA group had a significantly lower hemoglobin drop (1.7 g/dL vs. 2.5 g/dL), lower drain output (154 mL vs. 203 mL), lower hidden blood loss (244 mL vs. 423 mL) and lower total blood loss (398 mL vs. 626 mL). There was no difference in transfusion rate (1.1% vs. 3.2%) and thromboembolic complication. There was no infection or mortality in both groups.ConclusionsOral TXA is effective in reducing blood loss in primary total knee replacement. It is a safe alternative to the intravenous or topical form.

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“…Hypersensitivity reactions such as rash occur occasionally 53 and anaphylaxis to TA has been reported. 54 Additional, albeit uncommon (!1%) adverse events include change in mood, giddiness, low blood pressure/orthostatic reactions, myalgias, muscle tenderness, skin rash, and alteration in color vision. 50 We also inform patients that both agents carry a risk, albeit theoretical of thrombosis.…”

Section: Nonmenstrual Bleedingmentioning

confidence: 99%