Table 2.
Diagnostic tests
| Series number | Operation | Allergy trigger | Serial tryptase | Skin prick test | Intra dermal test | IgE |
|---|---|---|---|---|---|---|
| 1 | MVR | Co-amoxiclav | Dynamic tryptase rise | Negative to all | Positive to co-amoxiclav | Not done |
| 2 | CABG+AVR | Blood products | Not done | Not done | Not done | No rise |
| 3 | CABG+AVR | Co-amoxiclav | No rise | Negative to all | Positive to co-amoxiclav | Positive to amoxicillin |
| 4 | CABG | Co-amoxiclav or tranexamic acid | Dynamic tryptase rise | Negative to all | Positive to tranexamic acid | Positive to amoxicillin |
| 5 | CABG | Pancuronium | Not done | Positive to Pancuronium | Not done | Not done |
| 6 | CABG | Chlorhexidine or latex | Dynamic tryptase rise | Positive chlorhexidine & latex | Positive to chlorhexidine & latex | Positive to chlorhexidine |
| 7 | Redo-CABG | Penicillin | Dynamic tryptase rise | Negative to all | Negative to all | Positive to penicillin |
| 8 | Redo-CABG | Co-amoxiclav | Dynamic tryptase rise | Negative to all | Negative to all | Not done |
| 9 | AVR | Chlorhexidine | Dynamic tryptase rise | Positive to chlorhexidine | Not done | Positive to chlorhexidine |
| 10 | CABG | Unknown (potentially chlorhexidine) | Dynamic tryptase rise | Negative to all | Negative to all | All negative |
| 11 | AVR | Gelofusine | Dynamic tryptase rise | Negative to all | Positive to gelofusine | Positive to gelofusine |
| 12 | CABG+AVR | Flucloxacillin or pancuronium | Not done | Positive to flucloxacillin & pancuronium | Not done | Not done |
| 13 | AVR | Gelofusine | Dynamic tryptase rise | Negative to all | Positive to gelofusine | Positive to gelofusine |
| 14 | CABG | Gelofusine | Dynamic tryptase rise | Negative to all | Positive to gelofusine | Not done |
| 15 | CABG | Rocuronium | Dynamic tryptase rise | Positive to rocuronium & suxamethonium | Not done | Positive to rocuronium |
| 16 | AVR | Chlorhexidine | Dynamic tryptase rise | Positive to chlorhexidine | Not done | Positive to chlorhexidine |
| 17 | CABG | Suxamethonium | Dynamic tryptase rise | Positive to suxamethonium | Not done | Not done |
| 18 | MVR+TVR | Gelofusine | Dynamic tryptase rise | Positive to gelofusine | Positive to gelofusine | Positive to gelofusine |
| 19 | CABG | Gelofusine or rocuronium | Dynamic tryptase rise | Negative to all | Equivocal to rocuronium and gelofusine | Mild rise to gelofusine |
MVR - Mitral valve replacement, CABG - Coronary artery bypass grafting, AVR - Aortic valve replacement, TVR - Tricuspid valve replacement