Teixeira Vera Coelho, Neves Maria Amélia, de Castro Roberto Almeida
Hospital Felício Rocho, Belo Horizonte, Minas Gerais.
Rev Bras Anestesiol. 2010 Sep-Oct;60(5):544-50. doi: 10.1016/S0034-7094(10)70066-0.
The knowledge of anesthesiologists of specific aspects of patients with rare syndromes is a growing need since those patients are increasingly taken to the operating room. The objective of this report was to describe a case of latex allergy in a patient with Kabuki Syndrome, whose aspects have not been completely explained, alerting anesthesiologists for the possibility of this association.
This is an 11 years old patient with the diagnosis of Kabuki syndrome, admitted for removal of soft tissue lesions. She had a history of allergic reactions after small surgeries. Since she needed to undergo another procedure, after the pre-anesthetic evaluation the patient was referred to an allergist who confirmed, after skin tests, that the patient had latex allergy. She was taken to the operating room for removal of those lesions under general anesthesia. All precautions were taken to avoid new clinical manifestations. Intercurrences were not observed during the procedure and the patient was discharged on the same day without any complications, which reinforced the diagnosis.
Kabuki syndrome seems to have a relatively benign course. However, it has many aspects that remain to be cleared and, therefore, the possibility of its association with other condition that might be important for the anesthesiologist exists. The objective of this report was to alert for the risk of its association with latex allergy. For such, during the pre-anesthetic evaluation, a good anamnesis with analysis of predisposing factors other than the syndrome itself should be stimulated.
由于越来越多患有罕见综合征的患者被送往手术室，麻醉医生了解这些患者特定方面的知识变得愈发必要。本报告的目的是描述一例歌舞伎综合征患者的乳胶过敏病例，其相关情况尚未完全阐明，以此提醒麻醉医生注意这种关联的可能性。
这是一名11岁诊断为歌舞伎综合征的患者，因软组织肿物切除术入院。她有过小型手术后过敏反应的病史。由于她需要接受另一项手术，在麻醉前评估后，该患者被转诊至过敏症专科医生处，经皮肤试验后，过敏症专科医生确认该患者对乳胶过敏。她在全身麻醉下被送往手术室切除肿物。采取了一切预防措施以避免出现新的临床表现。手术过程中未观察到任何意外情况，患者于当日出院，无任何并发症，这进一步证实了诊断。
歌舞伎综合征似乎病程相对良性。然而，其仍有许多方面有待明确，因此存在与其他对麻醉医生可能重要的情况相关联的可能性。本报告的目的是提醒注意其与乳胶过敏相关联的风险。为此，在麻醉前评估期间，应鼓励进行全面的病史询问，分析除综合征本身之外的诱发因素。
