scholarly journals Clinical Characteristics and Allergen Detection of Perioperative Anaphylaxis: A 12-year Retrospective Analysis from an Anesthesia Clinic in China

2021 ◽  
Author(s):  
Xiaowen Liu ◽  
Ruisong Gong ◽  
Xin Xin ◽  
Jing Zhao
Keyword(s):  
Diagnostic Tests ◽  
Clinical Characteristics ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Allergy Clinic ◽  
Blocking Agents ◽  
Allergen Detection ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Abstract Background: Anaphylaxis during anesthesia is a rare but often a potentially life-threatening event for patients. Identifying culprit agents responsible for anaphylaxis is of great important for avoiding potential re-exposure to allergens, but it poses great challenge for anesthetists. This retrospective study aimed to analyze the culprits of patients with a history of perioperative anaphylaxis referred to an anesthesia allergy clinic in China, and to evaluate the role of allergy diagnostic tests in clinical practice.Methods: A total of 145 patients (102 female/43 male) who attended the Anesthesia Allergy Clinic for allergen detection between 1 January 2009 and 31 December 2020 were reviewed retrospectively. Clinical characteristics, results of allergy diagnostic tests including skin and/or basophil activation tests, and the incidence of repeat anaphylaxis after use of recommended alternative anesthetics were obtained.Results: Of these 145 patients, 109 patients (75.2%, 74 females/35 males) were determined to experience perioperative anaphylaxis. The commonest presenting clinical feature was cardiovascular manifestations (n=63, 57.8%). According to diagnostic work up, the commonest culprits for perioperative anaphylaxis were neuromuscular blocking agents (n= 35, 32.1%). After diagnostic work up, 52 patients underwent repeat anesthesia, and none had recurrent anaphylaxis.Conclusions: This study suggests that neuromuscular blocking agents are the main culprits for perioperative anaphylaxis. For patients with perioperative anaphylaxis, allergy diagnostic tests are essential to identify causative agents, and to find suitable alternative drugs for the planning of repeat anesthesia.

scholarly journals Clinical characteristics and outcome of patients with autoimmune hemolytic anemia uniformly defined as primary by a diagnostic work-up

2016 ◽  
Vol 91 (7) ◽  
pp. E319-E320
Author(s):  
Francesca R. Mauro ◽  
Serelina Coluzzi ◽  
Francesca Paoloni ◽  
Fabio Trastulli ◽  
Daniele Armiento ◽  
...  
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Clinical Characteristics ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Reizdarmsyndrom – eine Krankheit

2018 ◽  
Vol 143 (06) ◽  
pp. 411-419
Author(s):  
Viola Andresen ◽  
Peter Layer
Keyword(s):  
Diagnostic Tests ◽  
Bacterial Infections ◽  
Specific Symptom ◽  
Abdominal Symptoms ◽  
Inflammatory Bowel ◽  
Irritable Bowel ◽  
Diagnostic Work ◽  
Work Up ◽  
Patient Guidance ◽  
Diagnostic Work Up

AbstractThe irritable bowel syndrome (IBS) counts among the most prevalent chronic diseases. Clinically, the IBS is characterized by abdominal symptoms combined with irregular defecation, which are not explained by routine diagnostic tests. IBS is often triggered by enteric bacterial infections, and its pathogenesis involves disturbed enteric, gut-brain, and cerebral mechanisms. Diagnostic work-up must aim to establish a positive IBS diagnosis, and to exclude serious underlying differential diagnoses (such as neoplasia, inflammatory bowel disease, celiac disease and others). On the other hand, it is important to avoid diagnostic “overkill” including repetitive testing. Successful treatment of IBS usually combines unspecific basic (nutritional, psychological, lifestyle etc.) measures with specific, symptom-oriented medical therapy. Therapeutic efficacy is greatly enhanced by ruling out worrying diagnostic uncertainties (reassurance), and by initiating positive patient guidance.

scholarly journals Stroke masquerading as cardiac arrest: the artery of Percheron

2021 ◽  
Vol 14 (1) ◽  
pp. e238681
Author(s):  
Megan Quetsch ◽  
Sureshkumar Nagiah ◽  
Stephen Hedger
Keyword(s):  
Cardiac Arrest ◽  
Clinical Assessment ◽  
Altered Consciousness ◽  
Cognitive Changes ◽  
Consciousness Level ◽  
Artery Of Percheron ◽  
Conscious Level ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

The artery of Percheron (AOP) is a rare arterial variant of the thalamic blood supply. Due to the densely packed collection of nuclei it supplies, an infarction of the AOP can be devastating. Here we highlight a patient who had an AOP stroke in the community, which was initially managed as cardiac arrest. AOP strokes most often present with vague symptoms such as reduced conscious level, cognitive changes and confusion without obvious focal neurology, and therefore are often missed at the initial clinical assessment. This case highlights the importance of recognising an AOP stroke as a cause of otherwise unexplained altered consciousness level and the use of MRI early in the diagnostic work-up.

scholarly journals Death of unknown cause? Post-mortem diagnosis of fulminant course of an EBV-associated secondary hemophagocytic lymphohistiocytosis

2021 ◽  
Author(s):  
Josia Fauser ◽  
Stefan Köck ◽  
Eberhard Gunsilius ◽  
Andreas Chott ◽  
Andreas Peer ◽  
...  
Keyword(s):  
Immune Response ◽  
Case Report ◽  
Macrophage Activation ◽  
Post Mortem ◽  
Life Threatening ◽  
Appropriate Therapy ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up ◽  
Secondary Hemophagocytic Lymphohistiocytosis

SummaryHLH is a life-threatening disease, which is characterized by a dysregulated immune response with uncontrolled T cell and macrophage activation. The often fulminant course of the disease needs a fast diagnostic work-up to initiate as soon as possible the appropriate therapy. We present herein the case of a 71-year-old patient with rapidly progressive hyperinflammatory syndrome, which post mortem resulted in the diagnosis of EBV-associated HLH. With this case report, we intend to highlight the relevance of the HScore in the diagnosis of HLH, to create a greater awareness for EBV as a trigger of HLH, and to demonstrate the importance of treating EBV-associated HLH as early as possible.

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