Causes of perioperative hypersensitivity reactions in the Netherlands from 2002 to 2014

Abstract

To the Editor, Although relatively rare, immediate perioperative hypersensitivity reactions (POH) are important complications of drug administration prior to, during and after surgical and other interventional procedures. Both the incidence of immediate POH and their major culprits are difficult to establish and vary considerably between reports; the incidence may be as high as 1:1250 or almost a tenfold lower. 1Most studies have a yield of positive allergy test results of 50% to 60%, suggestive of an immunoglobulin E (IgE)-mediated reaction.Neuromuscular blocking agents (NMBA) were shown to be the most common cause of immediate POH in various countries including France and Australia, 2 while other countries (USA, UK, Spain, Denmark) identify antibiotics to be the primary culprit. 1,3,4 Other frequently and increasingly identified culprits in POH are dyes, non-steroidal anti-inflammatory drugs (NSAID), induction agents and colloid solutions (reviewed in 1 ). Dyes such as patent blue

Anaphylaxis mortality in the perioperative setting: Epidemiology, elicitors, risk factors and knowledge gaps

“…Beta‐lactam antibiotics are increasingly implicated in PA mortality, specifically penicillin and cefazolin. This pharmacological drug has been consistently related to PA in the United Kingdom, the United States, Spain, the Netherlands, Denmark and France 3,4,21,22,24–27 …”

“…This pharmacological drug has been consistently related to PA in the United Kingdom, the United States, Spain, the Netherlands, Denmark and France. 3,4,21,22,[24][25][26][27] Data regarding elicitors specifically implicated in PA fatalities are scarce (Table 1). Australian data based on the National Coronial Information System (from 1997 to 2013) reported 147 anaphylaxis fatalities, 20% related to general anaesthetics.…”

Biomarker strategies for perioperative hypersensitivity reactions and severe eosinophilic asthma

“…Perioperative hypersensitivity reactions (POH) are infrequent but severe and potentially life‐threatening, with an incidence between 1:1,250 and 1:13,000. It is reported that the severity of POH is usually higher than for other causes of anaphylaxis, with increased morbidity and mortality 5,6 …”