Abstract
A 2 1/2 year old boy had a sudden, severe, and unexpected anaphylactoid reaction after an otherwise uncomplicated repair of a partial atrioventricular septal defect. The reaction, comprising haemorrhagic pulmonary oedema and peripheral circulatory collapse, followed neutralisation of heparin by protamine. Measurements of serum complement (C3 and C4) concentrations suggested that a pronounced consumption of complement occurred during the adverse response.
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Selected References
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- Chenoweth D. E., Cooper S. W., Hugli T. E., Stewart R. W., Blackstone E. H., Kirklin J. W. Complement activation during cardiopulmonary bypass: evidence for generation of C3a and C5a anaphylatoxins. N Engl J Med. 1981 Feb 26;304(9):497–503. doi: 10.1056/NEJM198102263040901. [DOI] [PubMed] [Google Scholar]
- Hammerschmidt D. E., Stroncek D. F., Bowers T. K., Lammi-Keefe C. J., Kurth D. M., Ozalins A., Nicoloff D. M., Lillehei R. C., Craddock P. R., Jacob H. S. Complement activation and neutropenia occurring during cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1981 Mar;81(3):370–377. [PubMed] [Google Scholar]
- Hohn D. C., Meyers A. J., Gherini S. T., Beckmann A., Markison R. E., Churg A. M. Production of acute pulmonary injury by leukocytes and activated complement. Surgery. 1980 Jul;88(1):48–58. [PubMed] [Google Scholar]
- Jastrzebski J., Sykes M. K., Woods D. G. Cardiorespiratory effects of protamine after cardiopulmonary bypass in man. Thorax. 1974 Sep;29(5):534–538. doi: 10.1136/thx.29.5.534. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lakin J. D., Blocker T. J., Strong D. M., Yocum M. W. Anaphylaxis to protamine sulfate mediated by a complement-dependent IgG antibody. J Allergy Clin Immunol. 1978 Feb;61(2):102–107. doi: 10.1016/0091-6749(78)90232-4. [DOI] [PubMed] [Google Scholar]
- Nordström L., Fletcher R., Pavek K. Shock of anaphylactoid type induced by protamine: a continuous cardiorespiratory record. Acta Anaesthesiol Scand. 1978;22(3):195–201. doi: 10.1111/aas.1978.22.3.195. [DOI] [PubMed] [Google Scholar]
- Olinger G. N., Becker R. M., Bonchek L. I. Noncardiogenic pulmonary edema and peripheral vascular collapse following cardiopulmonary bypass: rare protamine reaction? Ann Thorac Surg. 1980 Jan;29(1):20–25. doi: 10.1016/s0003-4975(10)61620-7. [DOI] [PubMed] [Google Scholar]
- Pavek K. Anaphylactic shock in the monkey: its hemodynamics and mediators. Acta Anaesthesiol Scand. 1977;21(4):293–307. doi: 10.1111/j.1399-6576.1977.tb01222.x. [DOI] [PubMed] [Google Scholar]
- Shapira N., Schaff H. V., Piehler J. M., White R. D., Still J. C., Pluth J. R. Cardiovascular effects of protamine sulfate in man. J Thorac Cardiovasc Surg. 1982 Oct;84(4):505–514. [PubMed] [Google Scholar]
- Siegel J., Rent R., Gewurz H. Interactions of C-reactive protein with the complement system. I. Protamine-induced consumption of complement in acute phase sera. J Exp Med. 1974 Sep 1;140(3):631–647. doi: 10.1084/jem.140.3.631. [DOI] [PMC free article] [PubMed] [Google Scholar]
