QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text PDF Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Articles Ahead of Print [Order Reprint] Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hofer, K. N Articles by Hendrick, A. E Search for Related Content PubMed PubMed Citation Articles by Hofer, K. N Articles by Hendrick, A. E

Possible Anaphylaxis after Propofol in a Child with Food Allergy

at time of writing, Drug Information Resident, Department of Pharmacy Services, University of Virginia Health System, Charlottesville, VA; now, Drug Information Specialist, Department of Pharmacy Services, University of Virginia Health System

Michelle W McCarthy, PharmD

Drug Information Specialist, Department of Pharmacy Services, University of Virginia Health System

Marcia L Buck, PharmD FCCP

Pediatric Clinical Pharmacy Specialist, Children's Medical Center at the University of Virginia, Charlottesville, VA

Anne E Hendrick, PharmD

Manager, Drug Utilization and Drug Information Services, Department of Pharmacy Services, University of Virginia Health System

Reprints: Kristi N Hofer PharmD, Department of Pharmacy Services, University of Virginia Health System, PO Box 800674, Charlottesville, VA 22908-0674, FAX 434/982-1682, E-mail knp2p{at}virginia.edu

OBJECTIVE: To report a case of anaphylaxis due to propofol in a child with allergies to egg and peanut oil.

CASE SUMMARY: A 14-month-old boy with a history of reactive airway disease was hospitalized for treatment of respiratory symptoms. The patient had documented allergies to egg, peanut oil, and mold. Within the first few hours after admission, acute respiratory decompensation occurred, and arrangements were made to transfer the patient to our tertiary-care hospital. Prior to transfer, he was emergently intubated under sedation and paralysis with propofol and rocuronium. When emergency air transport arrived, the patient was hypotensive and tachycardic. His symptoms of anaphylaxis were managed throughout the flight and, upon arrival at our institution, the patient was admitted to the Pediatric Intensive Care Unit. He improved over a 5-day hospital course, and his caregivers were instructed to avoid propofol in the future. The patient's anaphylactic reaction following propofol was rated as a possible adverse drug reaction using the Naranjo probability scale.

DISCUSSION: The use of propofol in pediatric patients for procedural sedation has gained increased favor. Since the propofol formulation contains both egg lecithin and soybean oil, its use is contraindicated in patients with hypersensitivities to these components. Several other drugs have a food component, resulting in contraindications and warnings in product labeling.

CONCLUSIONS: Propofol should be avoided in patients with allergies to egg and/or soybean oil, if possible. Clinicians should consider the potential for adverse drug events in patients with select food allergies.

Key Words: anaphylaxis, food hypersensitivity, propofol

Published Online, February 9, 2003. www.theannals.com, DOI 10.1345/aph.1C227

This article has been cited by other articles:

				A. Duenas-Laita, F. Pineda, and A. Armentia Hypersensitivity to Generic Drugs with Soybean Oil N. Engl. J. Med., September 24, 2009; 361(13): 1317 - 1318. [Full Text] [PDF]