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Titolo:
HYDROXYETHYL STARCH ANTIBODIES IN HUMANS - INCIDENCE AND CLINICAL RELEVANCE
Autore:
DIETERICH HJ; KRAFT D; SIRTL C; LAUBENTHAL H; SCHIMETTA W; POLZ W; GERLACH E; PETER K;
Indirizzi:
UNIV TUBINGEN,DEPT ANAESTHESIOL,HOPPE SEYLER STR 3 D-72076 TUBINGEN GERMANY UNIV VIENNA,INST GEN & EXPT PATHOL VIENNA AUSTRIA RUHR UNIV BOCHUM,ST JOSEF HOSP,CLIN ANAESTHESIOL D-4630 BOCHUM GERMANY JOHANNES KEPLER UNIV,INST SYST SCI A-4040 LINZ AUSTRIA UNIV MUNICH,DEPT PHYSIOL D-8000 MUNICH GERMANY UNIV MUNICH,INST ANAESTHESIOL MUNICH GERMANY
Titolo Testata:
Anesthesia and analgesia
fascicolo: 5, volume: 86, anno: 1998,
pagine: 1123 - 1126
SICI:
0003-2999(1998)86:5<1123:HSAIH->2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANAPHYLACTOID REACTIONS; HYPERSENSITIVITY; SUBSTITUTES; INDUCTION; LATEX; IGE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
16
Recensione:
Indirizzi per estratti:
Citazione:
H.J. Dieterich et al., "HYDROXYETHYL STARCH ANTIBODIES IN HUMANS - INCIDENCE AND CLINICAL RELEVANCE", Anesthesia and analgesia, 86(5), 1998, pp. 1123-1126

Abstract

Hydroxyethyl starch (HES) is a plasma expander used for perioperativeIV fluid management, as well as for resuscitation from trauma and shock. HES is very well tolerated, and the incidence of anaphylactic reactions is lower than with dextran or gelatin. Dextran anaphylaxis is caused by circulating dextran-reactive antibodies (ABs) of the immunoglobin G (IgG) class found in most adults. Histamine release from mast cells induces adverse reactions after gelatin infusion. The cause of adverse reactions due to HES is not yet clear. To inves tigate AB formation due to HES, we collected sera of 1004 patients at least 14 days after starch administration. Using a highly sensitive enzyme-linked immunoabsorbent assay technique, we found one patient with a low 1:10 titerof HES-reactive ABs (immunoglobin M [IgM] class). Despite repeated HES infusions, no clinical reaction could be detected in this patient. On the basis of a binomial distribution, a one-tailed confidence interval (99%) was used to calculate the percentage of the occurrence of ABsin general with maximum of 33 in 10,000 persons (IgM) and 23 in 10,000 persons (IgG). We suggest that HES-reactive ABs are extremely rare and that they do not necessarily induce anaphylaxis. Other mechanisms may be responsible for adverse reactions due to HES. Implications: The frequency of antibody formation due to hydroxyethyl starch, a commonlyused plasma expander, was prospectively investigated in 1004 patients. Only one patient showed transient antibody formation, which was not harmful to the patient. This low antigenicity could explain the excellent tolerance of hydroxyethyl starch compared with other plasma expanders.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/21 alle ore 02:32:39