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A case of anaphylactic shock possibly caused by intravesical Hexvix ®
Author(s) -
Colapaoli L.,
Thorsen J.,
Nopp A.,
Guttormsen A. B.
Publication year - 2006
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2006.01110.x
Subject(s) - medicine , anaphylaxis , rash , cystoscopy , anesthesia , tryptase , vomiting , blood pressure , shock (circulatory) , transurethral resection of the prostate , allergy , surgery , urinary system , immunology , mast cell , prostate , cancer
Background: We report a case of a 69‐year‐old Caucasian male who experienced a severe drop in blood pressure and a skin rash after fluorescence cystoscopy and transurethral resection of the prostate. The diagnostic agent used for fluorescence cystoscopy and suspected of causing the anaphylaxis was hexaminolevulinate hydrochloride (Hexvix ® ). Incident: A profound fall in blood pressure associated with atrial fibrillation, the appearance of a rash, vomiting and transient loss of consciousness occurred immediately after surgery. The hypotension persisted for several hours despite intensive treatment. The reaction commenced approximately 5 h after exposure to Hexvix ® . There was an increase in serum tryptase (almost nine‐fold) and a positive skin prick test to undiluted Hexvix ® . Conclusion: The mechanism of the anaphylaxis is uncertain, but is considered likely to be a non‐immunoglobulin E‐mediated allergic reaction possibly caused by Hexvix ® . This is the first reported case of a severe allergic reaction after intravesical instillation of Hexvix ® .