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- Title
Novel mechanism of B cell‐mediated anaphylaxis after spinal anesthesia with bupivacaine.
- Authors
Yang, Meng‐Ta; Hwa, Su‐Yang; Liu, Feng‐Cheng; Lin, Tso‐Chou
- Abstract
In the first exposure, the allergen triggers naïve B cells to differentiate into plasma cells (CD19 SP + sp CD38 SP +++ sp ) and memory B cells (CD19 SP + sp CD38 SP - sp ).5 Plasma cells produce specific IgE antibodies to bind to the surface of circulating mast cells. Novel mechanism of B cell-mediated anaphylaxis after spinal anesthesia with bupivacaine The estimated incidence of perioperative grade 3-5 anaphylaxis is 1 per 10,000 patients administered anesthesia, with the leading causes being antibiotics, neuromuscular blocking agents, and chlorhexidine.1 Reports on severe allergic reactions to local anesthetics are rare,1,2 and few case reports have presented bupivacaine-induced anaphylaxis through symptomatic diagnosis and the lymphocyte stimulation test.3 To prevent anaphylaxis recurrence, diagnostic tests should be performed for culprit drug identification,4 including skin tests, intracutaneous tests, serum drug-specific immunoglobulin E (IgE) quantification, and basophil activation test.
- Subjects
SPINAL anesthesia; ANAPHYLAXIS; BUPIVACAINE; IMMUNOGLOBULIN producing cells; IMMUNOLOGIC memory
- Publication
Kaohsiung Journal of Medical Sciences, 2022, Vol 38, Issue 5, p496
- ISSN
1607-551X
- Publication type
Article
- DOI
10.1002/kjm2.12521