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Non-IgE-Dependent Hypersensitivity to Rocuronium Reversed by Sugammadex: Report of Three Cases and Hypothesis on the Underlying Mechanism.
- Source :
-
International archives of allergy and immunology [Int Arch Allergy Immunol] 2016; Vol. 169 (4), pp. 256-62. Date of Electronic Publication: 2016 May 31. - Publication Year :
- 2016
-
Abstract
- We present 3 cases of pseudoallergic (anaphylactoid) reactions to perioperatively administered rocuronium, which rapidly resolved after sugammadex injection. Allergological workup showed no evidence for immediate-type hypersensitivity to the drugs used for anesthesia, including rocuronium. However, rocuronium induced an irritative reaction in skin tests in all 3 patients and in 3 healthy individuals. This reaction was specifically suppressed by adding sugammadex at a 1:1 molecular proportion to rocuronium before the skin tests. This observation suggests that the patients suffered from a pseudoallergic reaction, and indicates that sugammadex might act via the inhibition of non-IgE mediated MRGPRX2 (Mas-related G-protein-coupled receptor member X2)-triggered mast cell degranulation induced by rocuronium.<br /> (© 2016 S. Karger AG, Basel.)
- Subjects :
- Adult
Aged
Drug Hypersensitivity diagnosis
Female
Humans
Male
Middle Aged
Phenotype
Rocuronium
Skin Tests
Sugammadex
Androstanols adverse effects
Drug Hypersensitivity drug therapy
Drug Hypersensitivity etiology
Neuromuscular Nondepolarizing Agents adverse effects
gamma-Cyclodextrins therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1423-0097
- Volume :
- 169
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- International archives of allergy and immunology
- Publication Type :
- Academic Journal
- Accession number :
- 27240836
- Full Text :
- https://doi.org/10.1159/000446182