An immediate, allergic skin reaction to aprotinin after reexposure to fibrin sealant.

Abstract:

BACKGROUND:The safety of fibrin tissue adhesives has been a concern since they entered wide clinical application. Most commercially available kits contain the proteolytic inhibitor, aprotinin, to stabilize the fibrin clot. A bovine protein, this substance has an allergenic potency. CASE REPORT:This case report presents a patient who had a generalized allergic skin reaction, probably triggered by aprotinin upon reexposure to fibrin sealant injected subgaleally to achieve closure of a liquor fistula after neurosurgical treatment. The serologic investigation revealed aprotinin-specific IgE and IgG. From 1990 through 1998, reports of five allergic reactions following 1 million exposures to fibrin sealant were made to the manufacturer. The clinical relevance of allergic reactions to aprotinin contained in fibrin sealants and measures to avoid them are discussed. CONCLUSION:These hypersensitivity reactions are extremely rare (incidence, 0.5/100,000 for all reactions and 0.3/100,000 for serious reactions), but they must be kept in mind as possible adverse events after repeated applications of fibrin sealants within a few weeks.

journal_name

Transfusion

journal_title

Transfusion

authors

Beierlein W,Scheule AM,Antoniadis G,Braun C,Schosser R

doi

10.1046/j.1537-2995.2000.40030302.x

subject

Has Abstract

pub_date

2000-03-01 00:00:00

pages

302-5

issue

3

eissn

0041-1132

issn

1537-2995

journal_volume

40

pub_type

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