Anaphylaxis due to suxamethonium in a 7-year-old child: a 14-year follow-up with allergy testing

Abstract

In 1973 a 7-year-old girl had anaphylactic reactions after two general anaesthetics. In-vitro testing with the leucocyte challenge histamine release test showed a strong response to suxamethonium, and other tests indirectly suggested an allergic mechanism. The conclusion was that this was an allergy to suxamethonium. Further blood was sent for testing against a range of neuromuscular blockers, but the patient was 'lost' until she re-appeared 14 years later as an antenatal patient. In-vitro testing was repeated against suxamethonium and all the available neuromuscular blockers after delivery. The radio-allergosorbent test for allergen-specific IgE antibodies was performed on newly collected serum and that which had been stored for 13-14 years. Skin testing was also performed. The results remain positive and suggest a degree of allergy to all the neuromuscular blockers with the possible exception of vecuronium. The radio-allergosorbent test was negative in the patient's baby.