A Case of Anaphylaxis to Patent Blue in a Patient with Sentinel Lymph Node Excision

• Main Authors: Stefanie Aurich, Anna-Theresa Seitz, Janina Tomm, Jan-Christoph Simon, Regina Treudler
• Format: Article
• Language: English
• Published: Tehran University of Medical Sciences 2017-12-01
• Series: Iranian Journal of Allergy, Asthma and Immunology
• Subjects: Allergy; Anaphylaxis; Blue dye; Breast cancer; Patent blue violet; Sentinel lymph node excision
• Online Access: https://ijaai.tums.ac.ir/index.php/ijaai/article/view/760

In medicine, patent blue violet (PBV) is utilized for staining lymphatic vessels in sentinel lymph node (SLN) surgery. Moreover, PBV (also called E131 ) is used as food additive. We report on a 51-year-old non-atopic female with early breast cancer, who was scheduled for SLN excision and experienced an intra-operative anaphylactic reaction. In diagnostics the skin prick test (SPT) was positive to PBV. Hypersensitivity reactions to PBV can arise after the first exposure in surgery as sensitization may arise from either PBV (E131) in foods (i.e. in sweets or blue curacao) or from other structurally closely related triarylmethane dyes in objects of everyday life like textiles, detergents, paints, cold remedies and cosmetics. This article supports the necessity of an increased awareness of the possibility of anaphylactic reactions to PBV during SLN surgery, even if the patient never had contact to PBV before.