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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Anaphylactic risk due to systemic mastocytosis: Perioperative management in card...
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Vol. 66. Issue 6.
Pages 346-349 (June - July 2019)
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Vol. 66. Issue 6.
Pages 346-349 (June - July 2019)
Case report
DOI: 10.1016/j.redare.2019.01.007
Anaphylactic risk due to systemic mastocytosis: Perioperative management in cardiac surgery
Riesgo anafiláctico por mastocitosis sistémica: manejo perioperatorio en cirugía cardíaca
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P. Martín Serranoa,
Corresponding author
pmartins@salud.madrid.org

Corresponding author.
, J.G. Martín Hernándeza, R. Martín Celemína, N. de Antonio Antónb, R. Orús Garcíac, A. Planas Rocaa
a Servicio de Anestesiología y Reanimación, Hospital Universitario de La Princesa, Madrid, Spain
b Servicio de Cirugía Cardíaca, Hospital Universitario de la Princesa, Madrid, Spain
c Servicio de Anestesiología y Reanimación, Hospital Universitario de Burgos, Burgos, Spain
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Abstract

Mastocytosis is a disease characterised by an abnormal proliferation of mast cells. The degranulation of mast cells can be triggered by chemical, physical, and psychological factors, and in severe cases may be accompanied by cardiovascular alterations and shock. Tryptase concentrations greater than 20μg/L may be associated with an increased risk of mastocyte degranulation. The case is presented on a 71 year-old man that underwent an aortic valve replacement and aortic-coronary bypass surgery. He had an indolent systemic mastocytosis and a history of histaminergic crises, with a baseline value of tryptase prior to surgery of 58.1μg/L.

Keywords:
Mastocytosis
Cardiac surgery
Anaphylaxis
Prevention
Pre-medication
Resumen

La mastocitosis es una enfermedad caracterizada por una proliferación anormal de los mastocitos. La degranulación de los mastocitos puede desencadenarse por factores químicos, físicos y psíquicos, y en casos graves puede cursar con alteraciones cardiovasculares y shock. Concentraciones de triptasa superiores a 20mcg/l se podrían correlacionar con mayor riesgo de degranulación mastocitaria. Presentamos el caso de un varón de 71 años sometido a cirugía de sustitución valvular aórtica y derivación aortocoronaria con mastocitosis sistémica indolente, con antecedentes de crisis histaminérgicas y con valores basales previos a la cirugía de tripatasa de 58,1mcg/l.

Palabras clave:
Mastocitosis
Cirugía cardíaca
Anafilaxia
Prevención
Premedicación

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