PMID- 15316522
OWN - NLM
STAT- MEDLINE
DCOM- 20040916
LR  - 20131121
IS  - 0091-6749 (Print)
IS  - 0091-6749 (Linking)
VI  - 114
IP  - 2
DP  - 2004 Aug
TI  - Nine episodes of anaphylaxis following cystoscopy caused by Cidex OPA 
      (ortho-phthalaldehyde) high-level disinfectant in 4 patients after cytoscopy.
PG  - 392-7
AB  - BACKGROUND: Ortho-phthalaldehyde (OPA) is a high-level disinfectant commonly used 
      for processing heat-sensitive medical devices. OBJECTIVE: We report 4 patients 
      who experienced 9 episodes of anaphylaxis following cystoscopy after a urology 
      practice switched from using Cidex (glutaraldehyde [GTA]) to OPA for disinfecting 
      their cystoscopes. METHODS: Allergic evaluations consisted of: skin testing to 
      saline, histamine, glycerin, lidocaine, latex, GTA, and OPA and blood tests for 
      total immunoglobulin E (IgE) and latex specific IgE. FINDINGS: The 4 patients 
      were evaluated after 3 of them had experienced 2 episodes of anaphylaxis and one 
      of them 3 episodes following outpatient cystoscopy for ongoing evaluation of 
      bladder cancer. Skin testing of subjects and controls to lidocaine, latex, latex 
      specific IgE, and GTA was negative. Skin testing to OPA resulted in immediate 
      wheal and flare reactions in all 4 patients within 20 minutes and late reactions 
      at 24 hours but negative reactions in controls. Subsequent to the testing, 3 of 
      the patients returned for repeat cystoscopy in which GTA but not OPA was used to 
      disinfect the cystoscopes and tolerated the procedure. CONCLUSIONS: OPA solution 
      should be considered a cause of anaphylactic/allergic reactions following 
      cystoscopy and possibly following instrumentation with other medical devices 
      disinfected by this material.
FAU - Sokol, William N
AU  - Sokol WN
AD  - University of California, Irvine College of Medicine, Newport Beach, CA 92660, 
      USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Allergy Clin Immunol
JT  - The Journal of allergy and clinical immunology
JID - 1275002
RN  - 0 (Disinfectants)
RN  - T3C89M417N (Glutaral)
SB  - IM
MH  - Aged
MH  - Anaphylaxis/*etiology
MH  - Cystoscopy/*adverse effects
MH  - Disinfectants/*adverse effects
MH  - Glutaral/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Skin Tests
EDAT- 2004/08/19 05:00
MHDA- 2004/09/17 05:00
CRDT- 2004/08/19 05:00
PHST- 2004/08/19 05:00 [pubmed]
PHST- 2004/09/17 05:00 [medline]
PHST- 2004/08/19 05:00 [entrez]
AID - S0091674904014010 [pii]
AID - 10.1016/j.jaci.2004.04.031 [doi]
PST - ppublish
SO  - J Allergy Clin Immunol. 2004 Aug;114(2):392-7. doi: 10.1016/j.jaci.2004.04.031.