PMID- 1379418
OWN - NLM
STAT- MEDLINE
DCOM- 19920903
LR  - 20190628
IS  - 0003-3022 (Print)
IS  - 0003-3022 (Linking)
VI  - 77
IP  - 2
DP  - 1992 Aug
TI  - Life-threatening anaphylactoid reactions to propofol (Diprivan).
PG  - 275-80
AB  - Fourteen patients who had had a life-threatening reaction within a few minutes 
      after receiving propofol (Diprivan) were investigated for anaphylaxis 4-6 weeks 
      after the incident. Three kinds of immunologic tests were carried out: skin tests 
      (prick tests and intradermal tests with the drugs used and Intralipid, the 
      solvent for propofol), a leukocyte histamine release test, and a radioimmunoassay 
      (RIA) of immunoglobulin E (IgE) against propofol and muscle relaxants, when they 
      had been given with propofol. It had been previously shown that these were always 
      negative in patients anesthetized with propofol without any complications. 
      Thirteen of the 14 patients had at least one positive test supporting 
      hypersensitivity to propofol; 2 patients had three tests positive; 4 had two 
      tests positive; and 7 had one test positive. The skin tests with Intralipid were 
      negative in 4 patients whose tests with propofol were positive. Two patients who 
      had been given muscle relaxants at the same time as the propofol had positive 
      IgE-RIA to both drugs. In one patient, results of all the tests remained 
      negative, and the mechanism involved in the reaction remained unidentified. It is 
      note-worthy that 9 patients of 14 had allergic histories that were known before 
      the anesthetic (atopy; allergy to antibiotics, muscle relaxants, lidocaine, 
      colloids) and that none of the patients had ever received propofol or Intralipid 
      before. It is possible that the IgE that linked abnormally with the propofol had 
      specific binding sites for the phenyl nucleus and the isopropyl groups, which are 
      present in propofol and many other drugs.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Laxenaire, M C
AU  - Laxenaire MC
AD  - Department of Anesthesiology and Surgical Intensive Care Unit, CHU-Hopital 
      Central, Nancy, France.
FAU - Mata-Bermejo, E
AU  - Mata-Bermejo E
FAU - Moneret-Vautrin, D A
AU  - Moneret-Vautrin DA
FAU - Gueant, J L
AU  - Gueant JL
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Anesthesiology
JT  - Anesthesiology
JID - 1300217
RN  - 37341-29-0 (Immunoglobulin E)
RN  - YI7VU623SF (Propofol)
SB  - IM
CIN - Anesthesiology. 1993 Mar;78(3):607-9. PMID: 7681272
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Anaphylaxis/*chemically induced/immunology
MH  - *Anesthesia, Intravenous
MH  - Basophils/drug effects
MH  - Child
MH  - Female
MH  - Histamine Release/drug effects
MH  - Humans
MH  - Immunoglobulin E/analysis
MH  - Male
MH  - Middle Aged
MH  - Propofol/*adverse effects
MH  - Retrospective Studies
MH  - Skin Tests
EDAT- 1992/08/01 00:00
MHDA- 1992/08/01 00:01
CRDT- 1992/08/01 00:00
PHST- 1992/08/01 00:00 [pubmed]
PHST- 1992/08/01 00:01 [medline]
PHST- 1992/08/01 00:00 [entrez]
AID - 10.1097/00000542-199208000-00009 [doi]
PST - ppublish
SO  - Anesthesiology. 1992 Aug;77(2):275-80. doi: 10.1097/00000542-199208000-00009.