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Title

Non-IgE-Dependent Hypersensitivity to Rocuronium Reversed by Sugammadex: Report of Three Cases and Hypothesis on the Underlying Mechanism

Authors
D'Incau, Stéphanie
Published in International Archives of Allergy and Immunology. 2016, vol. 169, no. 4, p. 256-262
Abstract We present 3 cases of pseudoallergic (anaphylactoid) reactions to perioperatively administered rocuronium, which rapidly resolved after sugammadex injection. Allergological workup showed no evidence for immediate-type hypersensitivity to the drugs used for anesthesia, including rocuronium. However, rocuronium induced an irritative reaction in skin tests in all 3 patients and in 3 healthy individuals. This reaction was specifically suppressed by adding sugammadex at a 1:1 molecular proportion to rocuronium before the skin tests. This observation suggests that the patients suffered from a pseudoallergic reaction, and indicates that sugammadex might act via the inhibition of non-IgE mediated MRGPRX2 (Mas-related G-protein-coupled receptor member X2)-triggered mast cell degranulation induced by rocuronium.
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PMID: 27240836
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Research group Etude de l'activation des monocytes/macrophages et des polynucléaires neutrophiles (779)
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SPOERL, David et al. Non-IgE-Dependent Hypersensitivity to Rocuronium Reversed by Sugammadex: Report of Three Cases and Hypothesis on the Underlying Mechanism. In: International Archives of Allergy and Immunology, 2016, vol. 169, n° 4, p. 256-262. https://archive-ouverte.unige.ch/unige:88480

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Deposited on : 2016-10-28

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