{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:43:29Z","timestamp":1787755409038,"version":"build-2784847793"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>We present 2 cases of life-threatening intraoperative anaphylaxis to the bovine flowable gelatin matrix during pediatric spinal deformity surgery for kyphoscoliosis. Both patients had no known bovine or gelatin allergies. Anaphylaxis occurred shortly after pressurized injection into the first cannulated pedicle tract and was successfully treated with epinephrine, diphenhydramine, and methylprednisolone infusion. The allergic reaction was confirmed with tryptase levels and serum-specific immunoglobulin E for beef, pork, bovine collagen, and porcine collagen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In patients with beef, pork, or gelatin intolerance, a significant atopic history or childhood vaccine reaction, preoperative allergy consultation, and testing should be performed to prevent this life-threatening complication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.21.00753","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T14:03:56Z","timestamp":1646316236000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Intraoperative Anaphylaxis to the Bovine Flowable Gelatin Matrix"],"prefix":"10.2106","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4033-4905","authenticated-orcid":false,"given":"Josephine R.","family":"Coury","sequence":"first","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, New York-Presbyterian\/Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kira F.","family":"Skaggs","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, New York-Presbyterian\/Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard F.","family":"Marciano","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, New York-Presbyterian\/Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4123-6733","authenticated-orcid":false,"given":"Teeda","family":"Pinyavat","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology, New York-Presbyterian\/Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7685-7284","authenticated-orcid":false,"given":"Mervat","family":"Naseef","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, New York-Presbyterian\/Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Roye","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, New York-Presbyterian\/Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Vitale","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, New York-Presbyterian\/Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,1]]},"reference":[{"issue":"4","key":"bib1-20240805","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1080\/21548331.2018.1498279","article-title":"FloSeal only versus in combination in spine surgery: a comparative, retrospective hospital database evaluation of clinical and healthcare resource outcomes","volume":"46","author":"Ramirez","year":"2018","journal-title":"Hosp Pract (1995)."},{"issue":"6","key":"bib2-20240805","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1080\/13696998.2017.1292916","article-title":"Cost-consequence analysis of two different active flowable hemostatic 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Int."},{"issue":"5","key":"bib6-20240805","doi-asserted-by":"crossref","first-page":"e58","DOI":"10.1097\/BPO.0b013e3182857d88","article-title":"Intraoperative anaphylaxis secondary to intraosseous gelatin administration","volume":"33","author":"Luhmann","year":"2013","journal-title":"J Pediatr Orthop."},{"issue":"1","key":"bib7-20240805","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jaip.2014.05.010","article-title":"Life-threatening intraoperative anaphylaxis to gelatin in FloSeal during pediatric spinal surgery","volume":"3","author":"Agarwal","year":"2015","journal-title":"J Allergy Clin Immunol Pract."},{"issue":"4","key":"bib8-20240805","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1007\/s43390-020-00273-4","article-title":"Anaphylaxis after injecting a hemostatic agent containing gelatin into vertebral bone under pressure\u2014a warning","volume":"9","author":"Bonanni","year":"2021","journal-title":"Spine 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J."},{"issue":"5","key":"bib12-20240805","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1016\/j.jaip.2017.06.030","article-title":"Gelatin anaphylaxis during surgery: a rare cause of perioperative anaphylaxis","volume":"5","author":"Raveendran","year":"2017","journal-title":"J Allergy Clin Immunol Pract."},{"issue":"2","key":"bib13-20240805","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1046\/j.1365-2567.1999.00696.x","article-title":"Reactivity of the immunoglobulin E in bovine gelatin-sensitive children to gelatins from various animals","volume":"96","author":"Sakaguchi","year":"1999","journal-title":"Immunology."},{"issue":"8","key":"bib14-20240805","doi-asserted-by":"crossref","first-page":"2994","DOI":"10.1016\/j.jaip.2021.03.011","article-title":"Use and interpretation of acute and baseline tryptase in perioperative hypersensitivity and anaphylaxis","volume":"9","author":"Vitte","year":"2021","journal-title":"J Allergy Clin Immunol 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