Hapten inhibition of dextran anaphylaxis. Nine years of post-marketing surveillance of dextran 1

Ljungström, Karl-Gösta; Willman, B.; Hedin, H.

doi:10.1016/s0750-7658(05)81033-0

Cited by 34 publications

(12 citation statements)

References 4 publications

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“…"pharmaceutical dextran"), which is known as one of the least biologically active polysaccharides (39), is a product of a microorganism (Leuconostoc Mesenteroides). Dextran is known to produce anaphylactoid reactions that are mediated by immunoglobulins specific to isomalto-oligosaccharides (40). The origin of the immunity is unknown; however, it has been shown recently that Streptococcus Sanguinus, an oral streptococcus prevalent in dental plaques (41), produces isomaltooligosaccharide containing lipoteichoic acid (42,43).…”

Section: Discussionmentioning

confidence: 99%

Acyclic Polyacetals from Polysaccharides: Biomimetic Biomedical "Stealth" Polymers

Papisov

2001

ACS Symposium Series

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Section: Discussionmentioning

confidence: 99%

Acyclic Polyacetals from Polysaccharides: Biomimetic Biomedical "Stealth" Polymers

Papisov

2001

ACS Symposium Series

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“…Severe DIAR is characterized by bronchospasm, profound hypotension, cardio-respiratory arrest and fatalities. In order to avoid this potentially life-threatening complication associated with dextran, the DIAR, hapten dextran (1 kDa) is infused before starting the first application of dextran (161,162). Nevertheless, accidents still happen (163,164).…”

Section: Plasma Volume Expanders (Colloids)mentioning

confidence: 99%

Anaphylaxis during anaesthesia: diagnostic approach

Ebo¹,

Fisher²,

Hagendorens³

et al. 2007

Allergy

192

197

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Anaesthesiologists administer several drugs while providing general anaesthesia. Many of these drugs can elicit adverse drug reactions that fall apart into two major types. First, reactions that are usually dose-dependent and related to the pharmacological properties of the drug and/or its metabolites. Second, reactions that are unrelated to the drug's pharmacological characteristics and that are less dose-dependent. These reactions comprise drug intolerance, idiosyncratic reactions and drug-induced immune-mediated allergic and nonimmune-mediated so-called pseudo-allergic or anaphylactoid reactions. The terms anaphylactic and anaphylactoid, however, have been used inconsistently in the literature. Therefore, the nomenclature task force set up by the European Academy of Allergy and Immunology (EAACI) has proposed that anaphylactic-type reactions should be reclassified into allergic anaphylaxis and nonallergic anaphylaxis. Allergic anaphylaxis being further subdivided in IgE-mediated and non-IgE-mediated reactions (1).The exact prevalence of anaphylaxis during anaesthesia is difficult to ascertain. The estimated overall frequency has been reported to vary between 1 in 3500 and 1 in 13 000 procedures in French series (2, 3) and between 1 in 10 000 and 1 in 20 000 in an Australian study (4). The clinical manifestation of these reactions is not infrequently an almost immediate generalized response with bronchospasm and hypotension. The degree of severity varies and does not allow differentiation between an IgE-mediated or non-IgE mediated reaction resulting from nonspecific mediator release (5). The mortality from these reactions is in the range from 3 to 6%, and an additional 2% of patients experience significant residual brain damage (4).Diagnosis of anaphylaxis during anaesthesia is not always straightforward. It can be hampered as a broad spectrum of different drugs can elicit heterogeneous allergic and nonallergic reactions with distinct and sometimes unclear pathological mechanisms. Problems are certainly compounded as multiple drugs need to be administered during general anaesthesia. In addition, nonanaesthesia related drugs or procedures (e.g. disinfection) are sometimes administered/performed in the perioperative period and can also be the cause of an allergic reaction.In addition, none of the available diagnostic tests demonstrates absolute accuracy. False-positive test Correct management of anaphylaxis during anaesthesia requires a multidisciplinary approach with prompt recognition and treatment of the acute event by the attending anaesthesiologist, and subsequent determination of the responsible agent(s) with strict avoidance of subsequent administration of all incriminated and/or cross-reacting compounds.However, correct identification of the causative compound(s) and safe alternatives is not always straightforward and, too often, not done.This review is not intended to discuss acute management of anaesthesia-related anaphylaxis but summarizes the major causes of anaphylaxis during anaesthesia and the di...

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“…Both increasing polymer size and variability of size have been hypothesized as stimulants of anaphylaxis. Supporting this notion is the observation that administration of dextran‐1, a small‐chain polymer with molecular weight of 1000 Da, can greatly reduce the risk of dextran‐induced anaphylaxis (21).…”

Section: Iron Dextranmentioning

confidence: 99%

The Comparative Safety of Intravenous Iron Dextran, Iron Saccharate, and Sodium Ferric Gluconate

Fishbane

Kowalski

2000

Seminars in Dialysis

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Intravenous iron treatment is an important component of anemia therapy for patients on dialysis. Until recently iron dextran was the only parenteral form of iron available in the United States. This drug has been associated with occasional serious adverse reactions, including full-blown anaphylaxis. In 1999 the Food and Drug Administration approved a second form of iron for intravenous administration, sodium ferric gluconate in sucrose. It is expected that by the time of this publication, a third agent, iron saccharate will also be approved. In this review the comparative safety of these three agents is critically evaluated.

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Hapten inhibition of dextran anaphylaxis. Nine years of post-marketing surveillance of dextran 1

Cited by 34 publications

References 4 publications

Acyclic Polyacetals from Polysaccharides: Biomimetic Biomedical "Stealth" Polymers

Acyclic Polyacetals from Polysaccharides: Biomimetic Biomedical "Stealth" Polymers

Anaphylaxis during anaesthesia: diagnostic approach

The Comparative Safety of Intravenous Iron Dextran, Iron Saccharate, and Sodium Ferric Gluconate

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