Trimmel Helmut, Tauber Wolfgang, Zikeli Martin
Department for Anesthesia Emergency and Intensive Medicine State Hospital of Wiener Neustadt, Corvinusring 3-5, Wiener Neustadt 2700, Austria.
Karl Landsteiner Institute for Emergency Medicine Medical Simulation and Patient Safety State Hospital of Wiener Neustadt, Corvinusring 3-5, Wiener Neustadt 2700, Austria.
Case Rep Neurol Med. 2024 Jul 18;2024:2332908. doi: 10.1155/2024/2332908. eCollection 2024.
In this case report, we describe a well-documented, severe anaphylactic reaction after intravenous administration of cerebrolysin, a neurotrophic agent derived from highly purified porcine brain tissue, consisting of peptides and free amino acids. Cerebrolysin has been in use for decades, in various neurological diseases, but especially stroke and traumatic brain injury, with the aim of enhancing cognitive performance. After administration of cerebrolysin to an 85-year-old male patient suffering from subacute stroke, he developed a fulminant anaphylactic reaction. Following institutional standards, vital functions were quickly restored. The anaphylactic reaction was clearly confirmed by laboratory tests. To date, only rare cases of anaphylaxis due to cerebrolysin have been published in the literature. The current report is intended to raise awareness for the possibility of such a reaction, given the widespread use of cerebrolysin in several indications in mostly critical patients. The case shows how a completely unexpected life-threatening situation can be successfully treated by targeted measures, if the situation is recognized quickly. In light of this event, we consider pathophysiology of allergic reactions and treatment guidelines.
在本病例报告中，我们描述了一例有充分记录的严重过敏反应，该反应发生在静脉注射脑蛋白水解物之后。脑蛋白水解物是一种神经营养药物，由高度纯化的猪脑组织提取而来，包含肽和游离氨基酸。脑蛋白水解物已应用数十年，用于多种神经系统疾病，尤其是中风和创伤性脑损伤，目的是提高认知能力。在给一名患有亚急性中风的85岁男性患者注射脑蛋白水解物后，他发生了暴发性过敏反应。按照机构标准，生命功能很快得以恢复。实验室检查明确证实了过敏反应。迄今为止，文献中仅发表了少数几例因脑蛋白水解物引起过敏反应的病例。鉴于脑蛋白水解物在大多数重症患者的多种适应症中广泛使用，本报告旨在提高对这种反应可能性的认识。该病例表明，如果能迅速识别情况，通过针对性措施可以成功治疗完全意想不到的危及生命的情况。鉴于此事件，我们探讨了过敏反应的病理生理学和治疗指南。
