Current opinion in allergy and clinical immunology
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Mastocytosis in adults is associated with a history of anaphylaxis in 22-49%. In addition, monoclonal mast cell activation syndrome has been described presenting with anaphylaxis, especially in patients with hymenoptera venom anaphylaxis. Data on patients with drug hypersensitivity and mast cell diseases are scarce. ⋯ The association between immediate drug hypersensitivity and undetected mast cell diseases appears to be moderate, but nevertheless basal serum tryptase determination and examination for skin signs of mast cell disorders are recommended. An ongoing European multicenter study by the European Network for Drug Allergy will provide more information on this topic.
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Curr Opin Allergy Clin Immunol · Aug 2012
ReviewHypersensitivity reactions in the anesthesia setting/allergic reactions to anesthetics.
Immediate hypersensitivity reactions are an important cause for mortality and morbidity in anesthesia. The present review considers reports covering epidemiology, diagnosis, and treatment of these reactions. ⋯ Hypersensitivity reactions remain a major cause of concern in the perioperative setting. Although largely under-reported, their incidence is higher than previously reported. NMBAs remain the most frequently incriminated drug, followed by latex and antibiotics. The number of reactions involving new allergens like vital dyes or nonsteroidal anti-inflammatory drugs is rapidly increasing. The mechanism of sensitization to NMBAs could be influenced by as yet unidentified environmental factors. The possible role of pholcodine is under investigation. Several guidelines concerning the diagnosis and management of immediate hypersensitivity reactions in anesthesia are now available.