Anafilaxia a opioides en un paciente oncológico pediátrico: reporte de caso

Autores/as

DOI:

https://doi.org/10.37711/rpcs.2020.2.3.197

Palabras clave:

humanos, tramadol, analgésicos, opioides síndrome de Down

Resumen

Se presenta el caso de un paciente de 5 años con diagnóstico de leucemia linfoblástica aguda y trisomía 21, quien fue  hospitalizado para manejo con quimioterapia de primera línea en quien se presentaron diversas complicaciones durante su tratamiento, por lo que requirió manejo antibiótico y analgésico opioide. Posteriormente, desarrolla cuatro reacciones alérgicas; tres de ellas asociadas a opioides y una catalogada como angioedema severo relacionado con tramadol. Se presenta el caso clínico debido a la baja incidencia de reacciones severas alérgicas a opioides, particularmente al tramadol en el contexto de pacientes de alta complejidad con polimedicación.

Descargas

Los datos de descarga aún no están disponibles.

Referencias

1. Patanwala AE, Keim SM, Erstad BL. Intravenous opioids for severe acute pain in the emergency department. The Annals of pharmacotherapy. 2010; 44(11): 1800-1809. https://doi.org/10.1345/aph.1P438

2. Meng J., Rotiroti G, Burdett E, Lukawska JJ. Anaphylaxis during general anaesthesia: experience from a drug allergy centre in the UK. Acta anaesthesiologica Scandinavica. 2017; 61(3): 281–289. https://doi.org/10.1111/aas.12858

3. Ariosto D. Factors Contributing to CPOE Opiate Allergy Alert Overrides. AMIA Annu Symp Proc [Internet] 2014; 2014: 256-265. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419937/

4. Kartal M, Oktay C, Bacanli A, karadeniz O. A Rare Diagnosis in Emergency Department: Morphine Related Anaphylactoid Reaction. Turkish Journal of Emergency Medicine [Internet] 2009; 9(4): 181-183. Disponible en: https://www.turkjemergmed.com/abstract/331

5. Montañez MI, Mayorga C, Bogas G, Barrionuevo E, Fernandez-Santamaria R, Martin-Serrano A, et al. Epidemiology, Mechanisms, and Diagnosis of Drug-Induced Anaphylaxis. Front. Immunol. 2017 May 29; 8:614. doi: 10.3389/fimmu.2017.00614

6. Baldo BA, Pham NH. Histamine-releasing and allergenic properties of opioid analgesic drugs: resolving the two. Anaesth Intensive Care. 2012; 40(2): 216-235. https://doi.org/10.1177/0310057X1204000204

7. Zhang B, Li Q, Shi C, Zhang X. Drug-Induced Pseudoallergy: A Review of the Causes and Mechanisms. Pharmacology. 2018; 101(1-2): 104–110. https://doi.org/10.1159/000479878

8. Gilbar PJ, Ridge AM. History of opioid allergy: what significance? J Oncol Pharm Pract. 2004; 10(3): 183-6. https://doi.org/10.1191/1078155204jp131oa

9. Kemp SF, Lockey RF. Anaphylaxis: a review of causes and mechanisms. The Journal of allergy and clinical immunology. 2002; 110(3): 341–348. https://doi.org/10.1067/mai.2002.126811

10. Mori F, Barni S, Manfredi M, Sarti L, Pecorari L, Pucci N, et al. Anaphylaxis to Intravenous Tramadol in a Child. Pharmacology. 2015; 96(5-6), 256–258. https://doi.org/10.1159/000441005

11. Hallberg P, Brenning G. Angioedema induced by trama-dol-a potentially life-threatening condition. European journal of clinical pharmacology, 2005; 60(12): 901–903. https://doi.org/10.1007/s00228-004-0882-5

12. Li PH, Ue KL, Wagner A, Rutkowski R, Rutkowski K. Opioid Hypersensitivity: Predictors of Allergy and Role of Drug Provocation Testing. The journal of allergy and clinical immunology. In practice. 2017; 5(6): 1601–1606. https://doi.org/10.1016/j.jaip.2017.03.035

13. Nasser SM, Ewan PW. Opiate-sensitivity: clinical charac-teristics and the role of skin prick testing. Clinical and experimental allergy: journal of the British Society for Allergy and Clinical Immunology. 2001; 31(7), 1014–1020. https://doi.org/10.1046/j.1365-2222.2001.01090.x

14. Baldo BA. Opioid Analgesic Drugs: Misuse, Toxicity, and Hypersensitivity. The journal of allergy and clinical immunology: In practice. 2017; 5(6): 1607–1608. https://doi.org/10.1016/j.jaip.2017.04.028

15. Sánchez-González MJ, Barbarroja-Escudero J, Antolín-Amérigo D, Rodríguez-Rodríguez M, Pericet L, Medina I, et al. Erythema Multiforme Induced by Tramadol: An Allergy Assessment. Journal of investigational aller-gology & clinical immunology. 2020; 30(4): 290–291. ht-tps://doi.org/10.18176/jiaci.0495

16. Sahutoglu C, Kocabas S, Askar FZ. Tramadol use in a patient with Brugada syndrome and morphine allergy: a case report. Journal of pain research. 2018; 11: 191-194. https://doi.org/10.2147/JPR.S150905

17. Wahler RG, Smith DB, Mulcahy KB. Nebulized Fentanyl for Dyspnea in a Hospice Patient with True Allergy to Morphine and Hydromorphone. Journal of pain & palliative care pharmacotherapy. 2017; 31(1): 38-42. https://doi.org/10.1080/15360288.2017.1279499

18. Kalangara J, Potru S, Kuruvilla M. Clinical Manifestations and Diagnostic Evaluation of Opioid Allergy Labels - A Review. Journal of pain & palliative care pharmacothera-py. 2019; 33(3-4): 131–140. https://doi.org/10.1080/15360288.2019.1666955

19. Li PH, Ue KL, Wagner A, Rutkowski R, Rutkowski K. Opioid Hypersensitivity: Predictors of Allergy and Role of Drug Provocation Testing. The journal of allergy and clinical immunology: In practice. 2017; 5(6), 1601-1606. https://doi.org/10.1016/j.jaip.2017.03.035

20. Sommerfield DL, Sommerfield A, Schilling A, Slevin L, Lucas M, Von Ungern-Sternberg BS. Allergy alerts - The incidence of parentally reported allergies in children presenting for general anesthesia. Paediatric anaesthesia. 2019; 29(2): 153-160. https://doi.org/10.1111/pan.13541

21. Kalangara J, Potru S, Kuruvilla M. Clinical Manifestations and Diagnostic Evaluation of Opioid Allergy Labels - A Review. Journal of pain & palliative care pharmacotherapy. 2019; 33(3-4): 131–140. https://doi.org/10.1080/15360288.2019.1666955

22. Powell MZ, Mueller SW, Reynolds PM. Assessment of Opioid Cross-reactivity and Provider Perceptions in Hospitalized Patients With Reported Opioid Allergies. The Annals of pharmacotherapy. 2019; 53(11): 1117-1123. https://doi.org/10.1177/1060028019860521

23. Benkhaial A, Kaltschmidt J, Weisshaar E, Diepgen TL, Haefeli WE. Prescribing errors in patients with documented drug allergies: comparison of ICD-10 coding and written patient notes. Pharmacy world & science: PWS. 2009; 31(4): 464-472. https://doi.org/10.1007/s11096-009-9300-5

24. Cabrera-Freitag P, Gastaminza G, Goikoetxea MJ, Lafuente A, De la Borbolla JM, Sanz ML. Immediate allergic reaction to atropine in ophthalmic solution confirmed by basophil activation test. Allergy. 2009; 64(9): 1388-1389. https://doi.org/10.1111/j.1398-9995.2009.02052.x

25. Brockow K, Romano A. Skin tests in the diagnosis of drug hypersensitivity reactions. Current pharmaceutical design. 2008; 14(27): 2778-2791. https://doi.org/10.2174/138161208786369821

26. Dewachter P, Lefebvre D, Kalaboka S, Bloch-Morot E. An anaphylactic reaction to transdermal delivered fentanyl. Acta anaesthesiologica Scandinavica. 2009; 53(8): 1092–1093. https://doi.org/10.1111/j.1399-6576.2009.02022.x

27. Baldo BA, Harle DG. Drug allergenic determinants. Monographs in allergy. 1990; 28: 11-51.

28. López-Marina V, Pizarro-Romero G, Costa-Bardají N. Neumonitis por hipersensibilidad asociada a tramadol [Hypersensitivity pneumonitis associated to tramadol]. Medicina clinica. 2006; 126(2): 77–78. https://doi.org/10.1157/13083574

29. Casale TB, Bowman S, Kaliner M. Induction of human cutaneous mast cell degranulation by opiates and endogenous opioid peptides: evidence for opiate and nonopiate receptor participation. The Journal of allergy and clinical immunology. 1984; 73(6), 775-781. https://doi.org/10.1016/0091-6749(84)90447-0

Descargas

Publicado

2020-09-01

Cómo citar

1.
Díaz Medina A. Anafilaxia a opioides en un paciente oncológico pediátrico: reporte de caso. Rev Peru Cienc Salud [Internet]. 2020 Sep. 1 [cited 2025 Aug. 27];2(3):e197. Available from: https://revistas.udh.edu.pe/RPCS/article/view/197e

Artículos similares

1-10 de 224

También puede Iniciar una búsqueda de similitud avanzada para este artículo.