Perioperative Anaphylaxis: Light at the End of the Tunnel

https://www.jaci-inpractice.org/article/S2213-2198(24)00337-4/fulltext

The Journal of Allergy and Clinical Immunology: In Practice, Volume 12, ISSUE 6, P1603-1604, June 2024, DOI: https://doi.org/10.1016/j.jaip.2024.03.044

Didier G. Ebo, MD, PhD, David M. Lang, MD, Dennis K. Ledford, MD

Perioperative anaphylaxis (POA) has a greater risk of death than do other types of anaphylaxis and occurs at a rate of 15.3 per 100,000 cases.

Evaluation of POA is complicated by the potential of multiple pharmacologic and nonpharmacologic anaphylactic exposures, simultaneously or in close succession. Moreover, the combination of effects of anesthetics that mimic hypersensitivity, pharmacologic and nonpharmacologic exposures, physiologic disruption by the surgical procedure and the anesthesia, inability of the patient to report symptoms, and numerous differential diagnoses complicate the evaluation of perioperative events. For these reasons, accurate diagnosis and identification of the causal agent of POA are challenging. Therefore, in 2019, an international hypersensitivity clinical scoring scheme was created to assess the likelihood that an adverse event in the perioperative period was an immediate hypersensitivity reaction.

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