Severe Anaphylaxis Associated with Isosulfan Blue Injection Used for Sentinel Node Detection: A First Case Report in Thai Breast Cancer Patients
Keywords:
Anaphylaxis, Breast cancer, Isosulfan blue dye, Sentinel node biopsyAbstract
Anaphylaxis is a severe systemic allergic reaction that generally manifests clinically as respiratory difficulty and circulatory collapse. It results from massive release of preformed mediators such as histamine from mast cell and basophils. Release of these mediators is caused by cellular binding of specific immunoglobulin-E antibodies. This release can produce a life threatening condition. There is a 1.5% reported incidence of allergic reaction to isosulfan blue dye, which has been used to localize the lymphatic system in breast surgery. Here, we report a 57-year-old Thai female presenting with severe anaphylaxis reaction from isosulfan blue injection for sentinel lymph node procedure in breast cancer. To the best of our knowledge, this is the first case report in Thailand. In addition, prophylaxis treatment for reducing severity of this condition is discussed.
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