Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Old, New and Hidden Causes of Perioperative Hypersensitivity

Research output: Contribution to journalReviewResearchpeer-review

  1. Chronic Inflammatory Diseases and Atherosclerotic Cardiovascular Disease: Innocent Bystanders or Partners in Crime?

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Management of antiepileptic treatment after epilepsy surgery - practices and problems

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. The role of antiplatelet therapy in primary prevention. A review

    Research output: Contribution to journalReviewResearchpeer-review

  4. Trimethylamine N-oxide (TMAO) as a new potential therapeutic target for insulin resistance and cancer

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Hyperpolarized (13)C MR Angiography

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Perioperative anaphylaxis in children: Etiology, time sequence, and patterns of clinical reactivity

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Undersøgelse og diagnostik af allergiske lidelser en kort gennemgang for tandlæger

    Research output: Contribution to journalJournal articleCommunication

  4. Chlorhexidine Allergy: Mild Allergic Reactions Can Precede Anaphylaxis in the Healthcare Setting

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Drug provocation testing: risk stratification is key

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Perioperative hypersensitivity reactions are rare, often life-threatening events, and subsequent investigations to identify the culprit are important to avoid re-exposure. All exposures in the perioperative setting may potentially be the cause of a hypersensitivity reaction, but drugs administered intravenously such as neuromuscular blocking agents (NMBA), induction agents and antibiotics have traditionally been reported to be implicated most commonly. It has recently become apparent that there are geographical differences in sensitization patterns related to variation in exposures, referral patterns and performance and interpretation of investigations. Differences in sensitization to NMBAs are partly explained by cross sensitization to pholcodine, an ingredient in cough-medicines available in some countries. While NMBAs are the most common causes of perioperative hypersensitivity in some countries, this may not necessarily be the case in all countries. New and hidden allergens have emerged as causes of perioperative hypersensitivity such as blue dyes, chlorhexidine and excipients. Detailed knowledge of the events at the time of reaction is necessary to identify potential culprits including rare and hidden allergens. Cooperation between allergists and anaesthetists, or other staff present perioperatively, is often needed to identify hidden or even undocumented exposures. The objectives of this review are to provide an overview of the history of investigation of perioperative hypersensitivity, to describe the differences in causes of perioperative hypersensitivity emerging over time and to increase awareness about the "hidden allergens" in the perioperative setting. Some practical advice on how to approach the patient testing negative on all initial investigations is also included.

Original languageEnglish
JournalCurrent Pharmaceutical Design
Volume22
Issue number45
Pages (from-to)6814-6824
Number of pages11
ISSN1381-6128
DOIs
Publication statusPublished - 2016

    Research areas

  • Anti-Bacterial Agents/adverse effects, Drug Hypersensitivity/diagnosis, Humans, Neuromuscular Blocking Agents/adverse effects

ID: 56716622