Perioperative anaphylaxis attributed to acetaminophen following intravenous acetaminophen administration: a case report.

IF 1 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-09-26 DOI:10.1186/s40981-025-00816-6

Yasuhiro Amano, Yosuke Taki, Yuko Konishi, Tasuku Fujii, Takahiro Tamura

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引用次数: 0

Abstract

Background: Anaphylaxis caused by intravenous acetaminophen is extremely rare, but a few case reports have identified mannitol, an excipient, as the causative component. Since mannitol is widely present in medications and foods, distinguishing the true antigen is essential to prevent recurrence.

Case presentation: A 67-year-old woman developed anaphylaxis with pulseless electrical activity during ophthalmic surgery after intravenous administration of acetaminophen (Acelio®). Allergy testing revealed positive reactions to both Acelio® and acetaminophen in skin tests and the basophil activation test, while reactions with mannitol were negative. Acetaminophen was confirmed as the causative agent. Hence, the patient was instructed to avoid only acetaminophen.

Conclusions: Accurate identification of the causative component in intravenous acetaminophen formulations is critical. Clarifying whether the reaction is due to the active ingredient or an excipient such as mannitol helps prevent unnecessary drug restrictions and expands future treatment options.

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静脉给药对乙酰氨基酚后引起的围手术期过敏反应：1例报告。

背景：静脉注射对乙酰氨基酚引起的过敏反应极为罕见，但少数病例报告已确定甘露醇，一种赋形剂，作为致病成分。由于甘露醇广泛存在于药物和食品中，区分真正的抗原对于预防复发至关重要。病例介绍：一名67岁女性在眼科手术中静脉注射对乙酰氨基酚（Acelio®）后出现无脉性电活动的过敏反应。过敏试验在皮肤试验和嗜碱性粒细胞激活试验中显示对Acelio®和对乙酰氨基酚均有阳性反应，而对甘露醇的反应为阴性。对乙酰氨基酚被证实为致病菌。因此，患者被告知只能避免使用对乙酰氨基酚。结论：准确鉴定静脉对乙酰氨基酚制剂中的致病成分至关重要。澄清反应是由活性成分引起的，还是由甘露醇等赋形剂引起的，有助于防止不必要的药物限制，并扩大未来的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.