Abstract
Dextran has been frequently used during intracoronary imaging, such as in optical
coherence tomography, optical frequent domain imaging, and coronary angioscopy. We
report a case of dextran-induced anaphylaxis in a 70-year-old male with chronic coronary
disease. Upon admission, we performed coronary angiography and coronary angioscopy
on the patient. After the intracoronary imaging, the patient's blood pressure suddenly
fell to 50 mmHg and a rash appeared on his chest. The patient was diagnosed as having dextran-induced
anaphylactic shock. Epinephrine was administered repeatedly, and his blood pressure
gradually recovered after administering a total of 6 mg epinephrine. There was no recurrence of the anaphylactic shock, and the patient
was discharged 12 days later. The incidence of dextran-induced anaphylactic reactions is extremely low;
however, they can be fatal. The possibility of anaphylactic shock induced by dextran
should be kept in mind by all cardiovascular interventionalists performing intracoronary
imaging.
Learning objective
Dextran has been frequently used during intracoronary imaging. We report on a case
of dextran-induced anaphylaxis in a 70-year-old male with chronic coronary disease.
While the incidence of dextran-induced anaphylactic reactions is extremely low, it
can lead to fatal events. The possibility of anaphylactic shock induced by dextran
should be kept in mind by all cardiovascular interventionalists while performing intracoronary
imaging.
Keywords
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Article info
Publication history
Published online: June 04, 2022
Accepted:
May 5,
2022
Received in revised form:
April 22,
2022
Received:
December 29,
2021
Footnotes
☆The work was performed at Hiroshima City Hiroshima Citizens Hospital.
Identification
Copyright
© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. All rights reserved.
