Anaphylaxis caused by γ-cyclodextrin in sugammadex

• Published in: Allergology International Vol. 65; no. 3; pp. 356 - 358
• Main Authors: Eri Hotta, Risa Tamagawa-Mineoka, Koji Masuda, Maiko Taura, Yuka Nakagawa, Fuminao Kanehisa, Saki Tashima, Norito Katoh
• Format: Journal Article
• Language: Japanese
• Published: JAPANESE SOCIETY OF ALLERGOLOGY 01.07.2016
• ISSN: 1323-8930; 1440-1592

Dear Editor, Sugammadex is a modified type of γ-cyclodextrin containing 8 thiopropionate side chains. It is used for the safe and rapid reversal of neuromuscular block, such as rocuronium or vecronium. Although several cases were reported as intraoperative anaphylaxis caused by sugammadex, the causative epitopes have not fully understood yet. Here, we present a case of anaphylaxis caused by the γ-cyclodextrin in sugammadex. A 65-year-old woman underwent an endoscopic left paranasal sinus operation for a left maxillary cyst. She had undergone surgery for ileus 15 years ago. She had no history of food, drug or other allergies and had not been exposed to sugammadex previously. At the end of the operation, 200 mg sugammadex were administered to reverse a rocuronium-induced neuromuscular block. Two minutes later, she developed hypotension (systolic arterial pressure: <60 mm Hg), and erythema over her whole body. After the administration of ephedrine and hydrocortisone sodium succinate, her symptoms improved.