Holstege Christopher P, Wu Jeffrey, Baer Alexander B
Department of Emergency Medicine, University of Virginia, Charlottesville, VA 22908-0699, USA.
Ann Emerg Med. 2002 Jun;39(6):677-9. doi: 10.1067/mem.2002.124442.
A 16-year-old boy presented to the emergency department with rapidly progressing extremity pain, edema, and ecchymosis after envenomation by a copperhead. Crotalidae polyvalent immune Fab (ovine) (CroFab; FabAV) was infused. Six vials were placed in 250 mL of normal saline solution, and the infusion was gradually increased. Fifty minutes after beginning, the infusion was increased to 640 mL/h. Within minutes of the rate increase, the patient experienced full-body urticaria, facial edema, voice change, and tachycardia. The infusion was stopped. Hydroxyzine pamoate, famotidine, methylprednisolone, and a 1-L bolus of normal saline solution were administered intravenously. The symptoms abated, and the remaining FabAV was infused at a slower rate without return of this reaction. This immediate hypersensitivity reaction was most likely a rate-related anaphylactoid reaction that has not been previously reported with FabAV.[Holstege CP, Wu J, Baer AB. Immediate hypersensitivity reaction associated with the rapid infusion of Crotalidae polyvalent immune Fab (ovine). Ann Emerg Med. June 2002;39:677-679.]
一名16岁男孩在被铜头蝮蛇咬伤后，因四肢疼痛、水肿和瘀斑迅速加重而被送往急诊科。给予了抗蛇毒血清（羊源）（CroFab；FabAV）静脉输注。将6瓶抗蛇毒血清置于250毫升生理盐水中，并逐渐加快输注速度。开始输注50分钟后，输注速度增加到640毫升/小时。在加快输注速度几分钟内，患者出现全身荨麻疹、面部水肿、声音改变和心动过速。输注停止。静脉注射了羟嗪双羟萘酸盐、法莫替丁、甲泼尼龙和1升生理盐水。症状缓解，剩余的FabAV以较慢速度输注，未再出现该反应。这种速发型超敏反应很可能是一种与输注速度相关的类过敏反应，此前尚未见FabAV引起此类反应的报道。[霍尔斯特格CP，吴J，贝尔AB。快速输注抗蛇毒血清（羊源）相关的速发型超敏反应。《急诊医学杂志》。2002年6月；39：677 - 679。]
