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- W2041862985 abstract "To the Editor: Levy and Adkinson1 have presented a useful overview of anaphylaxis occurring in patients during cardiac surgery. However, specific concerns are warranted regarding the interpretation of skin tests with neuromuscular blocking agents (NMBAs). The three studies2–4 cited by Levy and Adkinson1 were performed in control patients who did not experience an immediate hypersensitivity reaction during the perioperative period. In such circumstances, skin tests only refer to histamine release induced by NMBAs and cannot predict an anaphylactic reaction following IV administration of NMBAs because both negative as well as positive predictive values of skin tests with NMBAs in the general population are not known.5 In contrast, skin tests performed in patients with a history of immediate hypersensitivity with a NMBA are highly reliable.6 In those patients, prick-tests followed by intradermal tests (but not only prick-tests) are necessary to identify the pathophysiological mechanism of the reaction, the culprit allergen (like NMBAs) and potential cross-reactive molecules (cross-reactivity being about 60%–70% among NMBAs). NMBAs followed by a negative reaction by skin testing may be reinjected. In conclusion, the results of skin tests performed in individuals cannot and should not be compared with those performed in anaphylactic patients. Pascale Dewachter, MD, PhD Service d’Anesthésie-Réanimation et SAMU de Paris Hôpital Necker-Enfants Malades AP-HP, Université Paris Descartes [email protected] Claudie Mouton-Faivre, MD Pôle d’Anesthésie-Réanimation Chirurgicale CHU Hôpital Central Nancy, France" @default.
- W2041862985 created "2016-06-24" @default.
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- W2041862985 date "2008-10-01" @default.
- W2041862985 modified "2023-10-18" @default.
- W2041862985 title "Skin Testing Performed in Individuals Cannot be Compared with Responses from Anaphylactic Patients" @default.
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- W2041862985 doi "https://doi.org/10.1213/ane.0b013e3181827c42" @default.
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