Allergic reaction to patent blue dye in breast surgery – case report

Maranhão, Marcius Vinícius M.; Nóbrega, Dyluzia Kelly Amaral da; Anunciação, Carlos Eduardo; Maia, Barbara de Alcântara Brito; Mariano, Paulo

doi:10.1016/j.bjane.2014.02.018

Cited by 12 publications

(29 citation statements)

References 9 publications

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“…In spite of reports of hypersensitivity reactions with the use of methylene blue in canines, such as panniculitis and pigmentation of the inoculated region and other tissues, it is recommended to use 1 to 2 mL of contrast per animal [1,7,10,12,13]. Such alterations were not observed in the reported patient; and the dose used, although inferior to those described by some authors, allowed adequate dyeing.…”

Section: Discussionmentioning

confidence: 94%

Iliac Lymphadenectomy following Intrauterine Mapping in a Female Dog with Breast Neoplasm

Feranti

Coradini

Linhares

et al. 2018

Acta Scientiae. Vet.

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Background: The lymphatic system plays an important role in the local control of neoplasms as well as in the transportation of tumor cells, which represents the most common pathway of metastasis. From the tumorigenesis, there is a remarkable enlargement of the tumor drainage network towards the regional and target lymph nodes. Since the mammary lymphatic system of animals with neoplasms as well as the demarcation of the pelvic and abdominal caudal chain are poorly studied, the aim of the present study is to report a case of iliac lymphadenectomy after intrauterine lymphatic dyeing in a dog with breast neoplasm, which allowed the identification of metastasis in the medial iliac lymph node.Case: A 7-year-old, 13.4 kg, non neutered, mixed breed, female dog was diagnosed with ulcerative neoplasm in the left caudal abdominal breast, which presented evolution of approximately 90 days, presenting ulceration for 10 days, according to the tutor. After a clinical evaluation, thoracic radiography and abdominal ultrasonography were requested, whichdid not present metastasis suggestive images. Therefore, left unilateral total mastectomy was indicated. Retro-umbilical celiotomy was performed for the administration of 0.5 mL of 1% intrauterine methylene blue (body of the uterus), which allowed lymphatic mapping and medial iliac lymphadenectomy. Subsequently, ovariohysterectomy was performed andafter celiorrhaphy, axillary lymphadenectomy was performed, followed by left unilateral mastectomy and concomitant removal of the superficial inguinal lymph node. The patient had a prompt recovery and was discharged from hospital in six hours postoperatively. The excised material was referred for histopathological examination, which revealed the presence of metastasis of simple tubulopapillary carcinoma of the mammary gland in the left medial and superficial inguinal lymph nodes, while the axillary lymph node had no metastases. At the end of 10 days, the patient was clinically stable, with good healing of the surgical wound. After a 120-day postoperative period, the patient had a good clinical status, with no respiratory alterations, and there was no evidence of metastasis on the chest X-ray as well as abdominal ultrasound.Discussion: Considering the great occurrence of breast neoplasms, it is important to develop studies on new approaches in the therapeutic management of this condition and sharing of reports as described. The objective of the lymphadenectomy was to evaluate the possible involvement of regional lymph nodes, since, according to the condition of the lymph nodes in the histopathological examination, it appears as an important prognostic factor, seeing that the survival time is less thantwo years for 85.7% in dogs with regional lymph node metastases. In animals, there are no studies based on the therapeutic alternative of lymphadenectomy, which is believed to be palliative in the reported patient, due to the fact that it is a tubulopapillary carcinoma with different foci of lymph node metastases. Otherwise, lymphadenectomy enabled a better definition of the prognosis and proved to be an important tool for staging. The use of methylene blue was chosen because it was reportedly used in dogs, with excellent results in sentinel lymph nodes mapping, and due to its ease of obtaining and low cost of application. It is concluded that in canines with breast neoplasms, it is important to perform lymphatic mapping to identify possible metastases in cellular tissues and to delimit regional lymph vessels and lymph nodes, thus facilitating the surgical removal of these structures with safety margins. In addition, it is important to perform lymphadenectomy even to lymph nodes that are not infarcted or present macroscopic changes, given that in this case, it already existed metastasis, even in a lymph node of 4 mm.Keywords: metastasis, sentinel lymph node, lymphatic mapping, mastectomy, canine.

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Section: Discussionmentioning

confidence: 94%

Iliac Lymphadenectomy following Intrauterine Mapping in a Female Dog with Breast Neoplasm

Feranti

Coradini

Linhares

et al. 2018

Acta Scientiae. Vet.

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“…Enrofloxacin is effective against bacteria that are resistant to antibiotics such as aminoglycosides and tetracyclines. The superiority of enrofloxacin is related with the better tolerability in the gastrointestinal tract, good absorption after gastrointestinal and parenteral administration, good penetrance to tissues including prostate and joint liquids, large distribution volume, good penetrance to intracellular compartment and effect to intracellular bacteria and bactericidal effect at low concentrations [3,[7][8][9][10]15].…”

Section: Discussionmentioning

confidence: 99%

“…It is also used in intestinal infections caused by Escherichia coli, Salmonella species and Clostridium perfringens, respiratory infections caused by Pasteurella multocida, Pasteurella haemolytica, Haemophilus somnus, mastitis cases caused by E. coli, Klebsiella pneumoniae, Staphylococcus aureus and eye infections caused by Moraxella bovis [3,5]. The plasma half-life of enrofloxacin in calves is 5-6 h [10].…”

Section: Discussionmentioning

confidence: 99%

The Investigation of the Pharmacokinetics of Two Enrofloxacin Preparations Following Parenteral Administration in Calves

Bideci

Kaya

2018

Acta Scientiae. Vet.

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Background: Enrofloxacin is a bactericidal antimicrobial drug in the fluoroquinolone group, developed for use only in the veterinary field. It is effective against gram negative and gram positive bacteria, Mikoplazma, Rickettsia, Ehrlichia ve Chlamydia. Enrofloxacin is converted to several effective and ineffective metabolites including ciprofloxacin. Ten to fifty percent of the drug is eliminated via urine and bile in unmetabolized form. Enrofloxacin is used in all domestic animal including ruminant and winged animals. In calves, enrofloxacin finds utilization in the respiratory system infections, septicemia caused by colibacillosis and in cases of intestinal inflammation by oral and parenteral ways. There are around 1920 enrofloxacin preparations with different formulations in Turkey. Eight hundred fifty-five of these preparations are in the form of parenteral solutions that are ready for use. In this study, the pharmacokinetics of two enrofloxacin preparations that are used in calves were investigated.Materials, Methods & Results: Ten female calves (Jersey strain, 46-50 day-old) were included. The animals were taken to a separate environment 15 days in advance, and medication administration was restrained. Throughout the trial, the animals were fed with unmedicated feed. Calf growing feed, water, and hay were given freely as feed. They continued to be fed by 3 liters of milk twice a day. The study was reviewed by Ankara University Animal Trials Local Ethics Committee and approved with decision number 2007-7-17 and file number 2007-56. The calves were divided into two groups including five calves each. Reference drug and test drug were administered intramuscularly at a dose of 2.5 mg per kg to group 1 and group 2, respectively. Blood samples were taken before (0.0 min) and after the drug administration at 0.25, 0.5, 1, 2, 4, 8, 12, 18, 24 and 36th h. The method used by Anadon et al. was used for plasma enrofloxacin extraction and concentration. The chemicals, drugs, and solutions that were used in the study are acetonitrile, triethylamine, methanol, enrofloxacin (provided by Bayer Turk), reference drug (50 mg/mL injectable enrofloxacin, 20 mL per vial), test drug (100 mg/mL injectable enrofloxacin, 20 mL per vial). The pharmacokinetic variables were investigated after parenteral administration of reference and test drugs. The plasma concentration-time curve for each animal showed that enrofloxacin followed the two-compartment open model. There was statically significant differences in area under curve, absorption rate constant and absorption half-life between reference and test drugs (P < 0.05). However these differences were evaluated as insignificant from the point of clinical pharmacology. Peak plasma concentration was reached 0.8-1.2 h after the administration of both reference and test drugs. It was also seen that the drug concentration stayed above 0.5 µg/mL for approximately 4 h and decreases to 0.04 µg/mL at the 36th hour after administration.Discussion: The results obtained for both reference and test drugs in this study show that enrofloxacin is well absorbed from the gastrointestinal track. The drug concentration in plasma continues to be higher than 0.5 mg/mL during the first 24 h. The authors of this study think that the differences that were found in this study regarding pharmacokinetic variables are not significant regarding clinical pharmacology although some statistically significant differences were found. The results of this study imply that both reference and test drugs may be used interchangeably.

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“…Patent blue V dye (PBV) is part of the triarylmethane dye group 1–5. It is also known as E131, acid blue 3 or disulfine blue .…”

Section: Introductionmentioning

confidence: 99%

“…It is used as a food additive, cosmetics, textile dye and component of medicine products like laxatives 2 3 5–9. It is also commonly used as a perioperative drug to visualise lymph nodes in sentinel node biopsy (in the case of breast cancer and malignant melanoma) or in lymphadectomy,1–9 as well as in varicocelectomy 10 11. It is selectively absorbed by lymphatics, binds to albumin at a rate of 50%, and is secreted mainly in the bile and in the urine 3 6 8 9 12…”

Section: Introductionmentioning

confidence: 99%

Anaphylaxis to patent blue dye in a 17-year-old boy

Leung¹,

McCusker

Ben‐Shoshan

2019

BMJ Case Rep

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Patent blue V dye (PBV) is frequently used as a perioperative drug for lymphangiography, as well as a food additive. Hypersensitivity to PBV is poorly documented in adults and had not been previously described in children. The diagnosis of PBV allergy depends on corroboration of history consistent with an IgE-mediated reaction and confirmatory skin tests. We present in this paper a paediatric case of PBV anaphylaxis and of biphasic reaction that exemplifies the challenges involved in diagnosing and managing this rare but potentially life-threatening allergic reaction.

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Allergic reaction to patent blue dye in breast surgery – case report

Cited by 12 publications

References 9 publications

Iliac Lymphadenectomy following Intrauterine Mapping in a Female Dog with Breast Neoplasm

Iliac Lymphadenectomy following Intrauterine Mapping in a Female Dog with Breast Neoplasm

The Investigation of the Pharmacokinetics of Two Enrofloxacin Preparations Following Parenteral Administration in Calves

Anaphylaxis to patent blue dye in a 17-year-old boy

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