Amano Yasuhiro, Taki Yosuke, Konishi Yuko, Fujii Tasuku, Tamura Takahiro
Department of Anesthesiology, Nagoya University Graduate of School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan.
Department of Ophthalmology, Nagoya University Graduate of School of Medicine, Nagoya, Japan.
JA Clin Rep. 2025 Sep 26;11(1):52. doi: 10.1186/s40981-025-00816-6.
Anaphylaxis caused by intravenous acetaminophen is extremely rare, but a few case reports have identified mannitol, an excipient, as the causative component. Since mannitol is widely present in medications and foods, distinguishing the true antigen is essential to prevent recurrence.
A 67-year-old woman developed anaphylaxis with pulseless electrical activity during ophthalmic surgery after intravenous administration of acetaminophen (Acelio®). Allergy testing revealed positive reactions to both Acelio® and acetaminophen in skin tests and the basophil activation test, while reactions with mannitol were negative. Acetaminophen was confirmed as the causative agent. Hence, the patient was instructed to avoid only acetaminophen.
Accurate identification of the causative component in intravenous acetaminophen formulations is critical. Clarifying whether the reaction is due to the active ingredient or an excipient such as mannitol helps prevent unnecessary drug restrictions and expands future treatment options.
静脉注射对乙酰氨基酚引起的过敏反应极为罕见，但有少数病例报告确定辅料甘露醇为致病成分。由于甘露醇广泛存在于药物和食物中，鉴别真正的抗原对于预防复发至关重要。
一名67岁女性在眼科手术中静脉注射对乙酰氨基酚（Acelio®）后出现无脉电活动过敏反应。过敏试验显示，皮肤试验和嗜碱性粒细胞活化试验中对Acelio®和对乙酰氨基酚均呈阳性反应，而对甘露醇的反应为阴性。对乙酰氨基酚被确认为致病因素。因此，仅指示患者避免使用对乙酰氨基酚。
准确识别静脉注射对乙酰氨基酚制剂中的致病成分至关重要。明确反应是由活性成分还是甘露醇等辅料引起，有助于避免不必要的药物限制，并拓展未来的治疗选择。
