{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:38:32Z","timestamp":1790167112883,"version":"4.1.0"},"reference-count":2,"publisher":"Colegio Mexicano de Inmunologia Clinica y Alergia, A. C.","issue":"3","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Alerg Mex"],"abstract":"<jats:p>Antecedentes: La anafilaxia perioperatoria puede amenazar la vida del paciente. La incidencia global se estima 1 entre 10.000-20.000 procedimientos. Los agentes m\u00e1s frecuentes son bloqueadores neuromusculares, l\u00e1tex y antibi\u00f3ticos. Hay muy pocos reportes de alergia a anest\u00e9sicos inhalados como el sevoflurano, el cual se considera relativamente seguro en pacientes con alergia a f\u00e1rmacos.\nReporte de caso: Paciente de 12 a\u00f1os, ingres\u00f3 en oncolog\u00eda, diagn\u00f3stico de leucemia linfobl\u00e1stica aguda. Antecedente de dos reacciones de hipersensibilidad perioperatorias. En primer evento se administr\u00f3 lidoca\u00edna y rupivaca\u00edna, present\u00f3 urticaria, manejado con antihistam\u00ednico. Segunda ocasi\u00f3n recibi\u00f3 s\u00f3lo sevofluorano y present\u00f3 anafilaxia, tratado con adrenalina intramuscular. Posteriormente durante terapia intratecal, recibi\u00f3 sevoflurano, present\u00f3 rash e hipotensi\u00f3n arterial, manejo nuevamente con adrenalina, con remisi\u00f3n total de s\u00edntomas. Retrospectivamente criterios de Brighton nivel I de certeza, clasificada grave por Brown. Se sospech\u00f3 hipersensibilidad a sevoflurano, descartando otros anest\u00e9sicos como lidoca\u00edna y rupivacaina con pruebas cut\u00e1neas intrad\u00e9rmicas negativas. Se solicitaron componentes moleculares para l\u00e1tex con resultados negativos para Hev b 1, Hev b 3, Hev b 6. Por lo anterior y asociado a las caracter\u00edsticas del f\u00e1rmaco se realiza prueba de activaci\u00f3n de bas\u00f3filos para sevoflurano con un porcentaje de activaci\u00f3n del 50% (positivo). Se confirma anafilaxia perioperatoria por sevoflurano.\nConclusi\u00f3n: Deben considerarse todos los f\u00e1rmacos involucrados en las reacciones de hipersensibilidad perioperatoria, para establecer alternativas adecuadas y seguras de tratamiento de este peque\u00f1o grupo de pacientes.<\/jats:p>","DOI":"10.29262\/ram.v70i3.1271","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T08:02:08Z","timestamp":1694505728000},"page":"195","source":"Crossref","is-referenced-by-count":5,"title":["Anafilaxia perioperatoria a sevoflurano, un caso muy raro"],"prefix":"10.29262","volume":"70","author":[{"given":"Andrea Guadalupe","family":"Gonzalez Vallejo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Hern\u00e1ndez L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11808","published-online":{"date-parts":[[2023,8,21]]},"reference":[{"key":"54428","doi-asserted-by":"crossref","unstructured":"Di Leo E, Delle Donne P, Calogiuri GF, Macchia L, Nettis E. Focus on the agents most frequently responsible for perioperative anaphylaxis. Clin Mol Allergy. 2018;16:16. Published 2018 Jul 9. doi:10.1186\/s12948-018-0094-7","DOI":"10.1186\/s12948-018-0094-7"},{"key":"54429","doi-asserted-by":"crossref","unstructured":"Simonini A, Brogi E, Gily B, et al. Anaphylactic Shock During Pediatric Anesthesia: An Unexpected Reaction to Sevoflurane. Front Pediatr. 2018;6:236. Published 2018 Sep 7. doi:10.3389\/fped.2018.00236","DOI":"10.3389\/fped.2018.00236"}],"container-title":["Revista Alergia M\u00e9xico"],"original-title":[],"link":[{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1271\/2077","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1271\/2077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T08:02:15Z","timestamp":1694505735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/view\/1271"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,21]]},"references-count":2,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,9,11]]}},"URL":"https:\/\/doi.org\/10.29262\/ram.v70i3.1271","relation":{},"ISSN":["2448-9190","0002-5151"],"issn-type":[{"value":"2448-9190","type":"electronic"},{"value":"0002-5151","type":"print"}],"subject":[],"published":{"date-parts":[[2023,8,21]]}}}