PMID- 10818333
OWN - NLM
STAT- MEDLINE
DCOM- 20000706
LR  - 20190915
IS  - 0952-8180 (Print)
IS  - 0952-8180 (Linking)
VI  - 12
IP  - 2
DP  - 2000 Mar
TI  - Sudden bronchospasm on intubation: latex anaphylaxis?
PG  - 162-6
AB  - I present a case of a patient with a history of cerebral palsy and asthma, living 
      in a group home, who developed acute onset bronchospasm immediately after 
      intubation. The patient developed hypotension 5 minutes after intubation. The 
      bronchospasm lasted 20 minutes, and the case was complicated further by continued 
      hypotension and a pneumothorax. A diagnosis of latex-mediated anaphylaxis was 
      made in the intensive care unit after immunoglobin E (IgE), serum tryptase, and 
      latex-specific IgE antibody were shown to be markedly elevated. This case report 
      demonstrates that immediate onset of bronchospasm on intubation of an asthmatic 
      patient is not always an asthma attack, and that other causes of bronchospasm 
      should be considered in the differential diagnosis. Patients with a history of 
      atopy, including those with a history of asthma, have an increased risk of 
      developing latex sensitivity. It is important to remember that more than one 
      etiology may be responsible for this kind of bronchospasm, and that it may be 
      difficult to differentiate between multiple etiologies of bronchospasm.
FAU - Hepner, D L
AU  - Hepner DL
AD  - Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and 
      Women's Hospital, Boston, MA 02115, USA. dhepner@zeus.bwh.harvard.edu
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Clin Anesth
JT  - Journal of clinical anesthesia
JID - 8812166
RN  - 0 (Antibodies)
RN  - 0 (Inflammation Mediators)
RN  - 0 (Latex)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - EC 3.4.21.- (Serine Endopeptidases)
RN  - EC 3.4.21.- (chymase 2)
RN  - EC 3.4.21.39 (Chymases)
RN  - EC 3.4.21.59 (Tryptases)
SB  - IM
MH  - Adult
MH  - Anaphylaxis/*complications
MH  - Antibodies/blood
MH  - Asthma/complications
MH  - Bronchial Spasm/*etiology
MH  - Cerebral Palsy/complications
MH  - Chymases
MH  - Diagnosis, Differential
MH  - Humans
MH  - Hypotension/etiology
MH  - Immunoglobulin E/blood
MH  - Inflammation Mediators/blood
MH  - Intubation, Intratracheal/*instrumentation
MH  - Latex/immunology
MH  - Latex Hypersensitivity/*complications
MH  - Male
MH  - Pneumothorax/etiology
MH  - Serine Endopeptidases/blood
MH  - Tryptases
EDAT- 2000/05/20 09:00
MHDA- 2000/07/08 11:00
CRDT- 2000/05/20 09:00
PHST- 2000/05/20 09:00 [pubmed]
PHST- 2000/07/08 11:00 [medline]
PHST- 2000/05/20 09:00 [entrez]
AID - S0952-8180(00)00121-5 [pii]
AID - 10.1016/s0952-8180(00)00121-5 [doi]
PST - ppublish
SO  - J Clin Anesth. 2000 Mar;12(2):162-6. doi: 10.1016/s0952-8180(00)00121-5.