Tupker Ron A, Fransen Marloes, van Zuuren Esther J
St. Antonius Ziekenhuis, afd. Dermatologie, Nieuwegein.
Ned Tijdschr Geneeskd. 2014;158:A7556.
To determine the percentage of proven allergy for local anaesthetics (LA) in patients who were tested because of a clinical suspicion of LA allergy.
Retrospective multicentre case series.
All patients from two hospitals who were seen from 2004 through 2013 for a possible allergy to local anaesthetics. Their records were analyzed for the probable type of allergic reaction and allergy tests were performed. Distinction was made between skin prick tests (SPT), intradermal tests (IDT), subcutaneous provocation tests and epicutaneous tests (patch tests).
53 patients were included. The most common symptoms were dizziness (n = 14) and collapse (n = 12). Urticaria, oedema and/or erythema were seen in 25 patients, whilst 2 patients had a drop in blood pressure. In 4 patients an IgE-mediated allergy was proven by means of provocation testing. SPT and IDT were not predictive. In 1 patient a delayed-type allergy was established by patch testing.
IgE-mediated and delayed-type allergic reactions are rarely caused by LA. IgE-mediated reactions can be proven by provocation testing. Patch testing is used when a delayed type reaction is suspected.
确定因临床怀疑局部麻醉药（LA）过敏而接受检测的患者中，经证实的LA过敏百分比。
回顾性多中心病例系列研究。
对2004年至2013年期间两家医院中所有因可能对局部麻醉药过敏而就诊的患者进行研究。分析他们的记录以确定可能的过敏反应类型，并进行过敏测试。区分了皮肤点刺试验（SPT）、皮内试验（IDT）、皮下激发试验和表皮试验（斑贴试验）。
纳入53例患者。最常见的症状是头晕（n = 14）和虚脱（n = 12）。25例患者出现荨麻疹、水肿和/或红斑，2例患者血压下降。通过激发试验证实4例患者存在IgE介导的过敏反应。SPT和IDT无预测价值。1例患者通过斑贴试验确诊为迟发型过敏反应。
IgE介导的和迟发型过敏反应很少由LA引起。IgE介导的反应可通过激发试验证实。怀疑迟发型反应时采用斑贴试验。
