Non-IgE-Dependent Hypersensitivity to Rocuronium Reversed by Sugammadex: Report of Three Cases and Hypothesis on the Underlying Mechanism
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,...
Gespeichert in:
| Veröffentlicht in: | International archives of allergy and immunology 2016-01, Vol.169 (4), p.256-262 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 262 |
|---|---|
| container_issue | 4 |
| container_start_page | 256 |
| container_title | International archives of allergy and immunology |
| container_volume | 169 |
| creator | Spoerl, David D''Incau, Stéphanie Roux-Lombard, Pascale Harr, Thomas Czarnetzki, Christoph |
| description | 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. |
| doi_str_mv | 10.1159/000446182 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1159_000446182</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A637220496</galeid><sourcerecordid>A637220496</sourcerecordid><originalsourceid>FETCH-LOGICAL-c492t-d1e4be629c5f1520dab95e67b1468e477a490f8f65b20d51767a463dbca2d4583</originalsourceid><addsrcrecordid>eNpdkcFu1DAQhi0EomXhwB0hS0gIDgHbcRyHW7UUWqmAVNqz5SSTxCWxU9upyCPw1ni1yx44zWjmm39G8yP0kpIPlBbVR0II54JK9gidUs7yjJCqfJxyQmXGeC5P0LMQ7ghJsBRP0QkrGScyF6foz3dns8v-PPsMM9gWbMQX6ww-gA0mmgcTVxwdvnbN4p01y4Sv4WHXbnG94p9Lr6dJt_D7U6rPzkfsOnwzeAC81QEC1rbdCbo4QDABO4tThm_TJj-uxvb4GzSDtiZMz9GTTo8BXhziBt1-Ob_ZXmRXP75ebs-usoZXLGYtBV6DYFVTdLRgpNV1VYAoa8qFBF6Wmlekk50o6tQsaClSReRt3WjW8kLmG_Rurzt7d79AiGoyoYFx1BbcEhQtq5zRnBKe0Df_oXdu8TZdp6hMj06vTtIb9HZP9XoENYAe4xDcuETjbFBnIi8ZI7zage_3YONdCB46NXszab8qStTOSHU0MrGvD6uXeoL2SP5zLgGv9sAv7XvwR-Aw_xdfwKC5</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1814242346</pqid></control><display><type>article</type><title>Non-IgE-Dependent Hypersensitivity to Rocuronium Reversed by Sugammadex: Report of Three Cases and Hypothesis on the Underlying Mechanism</title><source>Karger Journals</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Spoerl, David ; D''Incau, Stéphanie ; Roux-Lombard, Pascale ; Harr, Thomas ; Czarnetzki, Christoph</creator><creatorcontrib>Spoerl, David ; D''Incau, Stéphanie ; Roux-Lombard, Pascale ; Harr, Thomas ; Czarnetzki, Christoph</creatorcontrib><description>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.</description><identifier>ISSN: 1018-2438</identifier><identifier>EISSN: 1423-0097</identifier><identifier>DOI: 10.1159/000446182</identifier><identifier>PMID: 27240836</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Adult ; Aged ; Allergies ; Androstanols - adverse effects ; Anesthesia ; Case studies ; Complications and side effects ; Drug hypersensitivity ; Drug Hypersensitivity - diagnosis ; Drug Hypersensitivity - drug therapy ; Drug Hypersensitivity - etiology ; Drug therapy ; Female ; gamma-Cyclodextrins - therapeutic use ; Health aspects ; Humans ; Immunoglobulin E ; Male ; Middle Aged ; Neuromuscular Nondepolarizing Agents - adverse effects ; Novel Insights from Clinical Practice ; Phenotype ; Rocuronium bromide ; Skin Tests ; Sugammadex</subject><ispartof>International archives of allergy and immunology, 2016-01, Vol.169 (4), p.256-262</ispartof><rights>2016 S. Karger AG, Basel</rights><rights>2016 S. Karger AG, Basel.</rights><rights>COPYRIGHT 2016 S. Karger AG</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c492t-d1e4be629c5f1520dab95e67b1468e477a490f8f65b20d51767a463dbca2d4583</citedby><cites>FETCH-LOGICAL-c492t-d1e4be629c5f1520dab95e67b1468e477a490f8f65b20d51767a463dbca2d4583</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,2433,27933,27934</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27240836$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spoerl, David</creatorcontrib><creatorcontrib>D''Incau, Stéphanie</creatorcontrib><creatorcontrib>Roux-Lombard, Pascale</creatorcontrib><creatorcontrib>Harr, Thomas</creatorcontrib><creatorcontrib>Czarnetzki, Christoph</creatorcontrib><title>Non-IgE-Dependent Hypersensitivity to Rocuronium Reversed by Sugammadex: Report of Three Cases and Hypothesis on the Underlying Mechanism</title><title>International archives of allergy and immunology</title><addtitle>Int Arch Allergy Immunol</addtitle><description>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.</description><subject>Adult</subject><subject>Aged</subject><subject>Allergies</subject><subject>Androstanols - adverse effects</subject><subject>Anesthesia</subject><subject>Case studies</subject><subject>Complications and side effects</subject><subject>Drug hypersensitivity</subject><subject>Drug Hypersensitivity - diagnosis</subject><subject>Drug Hypersensitivity - drug therapy</subject><subject>Drug Hypersensitivity - etiology</subject><subject>Drug therapy</subject><subject>Female</subject><subject>gamma-Cyclodextrins - therapeutic use</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Immunoglobulin E</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neuromuscular Nondepolarizing Agents - adverse effects</subject><subject>Novel Insights from Clinical Practice</subject><subject>Phenotype</subject><subject>Rocuronium bromide</subject><subject>Skin Tests</subject><subject>Sugammadex</subject><issn>1018-2438</issn><issn>1423-0097</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcFu1DAQhi0EomXhwB0hS0gIDgHbcRyHW7UUWqmAVNqz5SSTxCWxU9upyCPw1ni1yx44zWjmm39G8yP0kpIPlBbVR0II54JK9gidUs7yjJCqfJxyQmXGeC5P0LMQ7ghJsBRP0QkrGScyF6foz3dns8v-PPsMM9gWbMQX6ww-gA0mmgcTVxwdvnbN4p01y4Sv4WHXbnG94p9Lr6dJt_D7U6rPzkfsOnwzeAC81QEC1rbdCbo4QDABO4tThm_TJj-uxvb4GzSDtiZMz9GTTo8BXhziBt1-Ob_ZXmRXP75ebs-usoZXLGYtBV6DYFVTdLRgpNV1VYAoa8qFBF6Wmlekk50o6tQsaClSReRt3WjW8kLmG_Rurzt7d79AiGoyoYFx1BbcEhQtq5zRnBKe0Df_oXdu8TZdp6hMj06vTtIb9HZP9XoENYAe4xDcuETjbFBnIi8ZI7zage_3YONdCB46NXszab8qStTOSHU0MrGvD6uXeoL2SP5zLgGv9sAv7XvwR-Aw_xdfwKC5</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Spoerl, David</creator><creator>D''Incau, Stéphanie</creator><creator>Roux-Lombard, Pascale</creator><creator>Harr, Thomas</creator><creator>Czarnetzki, Christoph</creator><general>S. Karger AG</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Non-IgE-Dependent Hypersensitivity to Rocuronium Reversed by Sugammadex: Report of Three Cases and Hypothesis on the Underlying Mechanism</title><author>Spoerl, David ; D''Incau, Stéphanie ; Roux-Lombard, Pascale ; Harr, Thomas ; Czarnetzki, Christoph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c492t-d1e4be629c5f1520dab95e67b1468e477a490f8f65b20d51767a463dbca2d4583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Allergies</topic><topic>Androstanols - adverse effects</topic><topic>Anesthesia</topic><topic>Case studies</topic><topic>Complications and side effects</topic><topic>Drug hypersensitivity</topic><topic>Drug Hypersensitivity - diagnosis</topic><topic>Drug Hypersensitivity - drug therapy</topic><topic>Drug Hypersensitivity - etiology</topic><topic>Drug therapy</topic><topic>Female</topic><topic>gamma-Cyclodextrins - therapeutic use</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Immunoglobulin E</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neuromuscular Nondepolarizing Agents - adverse effects</topic><topic>Novel Insights from Clinical Practice</topic><topic>Phenotype</topic><topic>Rocuronium bromide</topic><topic>Skin Tests</topic><topic>Sugammadex</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spoerl, David</creatorcontrib><creatorcontrib>D''Incau, Stéphanie</creatorcontrib><creatorcontrib>Roux-Lombard, Pascale</creatorcontrib><creatorcontrib>Harr, Thomas</creatorcontrib><creatorcontrib>Czarnetzki, Christoph</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International archives of allergy and immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spoerl, David</au><au>D''Incau, Stéphanie</au><au>Roux-Lombard, Pascale</au><au>Harr, Thomas</au><au>Czarnetzki, Christoph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Non-IgE-Dependent Hypersensitivity to Rocuronium Reversed by Sugammadex: Report of Three Cases and Hypothesis on the Underlying Mechanism</atitle><jtitle>International archives of allergy and immunology</jtitle><addtitle>Int Arch Allergy Immunol</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>169</volume><issue>4</issue><spage>256</spage><epage>262</epage><pages>256-262</pages><issn>1018-2438</issn><eissn>1423-0097</eissn><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.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>27240836</pmid><doi>10.1159/000446182</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1018-2438 |
| ispartof | International archives of allergy and immunology, 2016-01, Vol.169 (4), p.256-262 |
| issn | 1018-2438 1423-0097 |
| language | eng |
| recordid | cdi_crossref_primary_10_1159_000446182 |
| source | Karger Journals; MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Aged Allergies Androstanols - adverse effects Anesthesia Case studies Complications and side effects Drug hypersensitivity Drug Hypersensitivity - diagnosis Drug Hypersensitivity - drug therapy Drug Hypersensitivity - etiology Drug therapy Female gamma-Cyclodextrins - therapeutic use Health aspects Humans Immunoglobulin E Male Middle Aged Neuromuscular Nondepolarizing Agents - adverse effects Novel Insights from Clinical Practice Phenotype Rocuronium bromide Skin Tests Sugammadex |
| title | Non-IgE-Dependent Hypersensitivity to Rocuronium Reversed by Sugammadex: Report of Three Cases and Hypothesis on the Underlying Mechanism |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-11-30T08%3A24%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Non-IgE-Dependent%20Hypersensitivity%20to%20Rocuronium%20Reversed%20by%20Sugammadex:%20Report%20of%20Three%20Cases%20and%20Hypothesis%20on%20the%20Underlying%20Mechanism&rft.jtitle=International%20archives%20of%20allergy%20and%20immunology&rft.au=Spoerl,%20David&rft.date=2016-01-01&rft.volume=169&rft.issue=4&rft.spage=256&rft.epage=262&rft.pages=256-262&rft.issn=1018-2438&rft.eissn=1423-0097&rft_id=info:doi/10.1159/000446182&rft_dat=%3Cgale_cross%3EA637220496%3C/gale_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1814242346&rft_id=info:pmid/27240836&rft_galeid=A637220496&rfr_iscdi=true |