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In this 274th episode I welcome Dr. Jonathan Kay (JK) to the show to discuss perioperative hypersensitivity reactions. We focus on the diagnosis and treatment of anaphylaxis and also discuss antibiotic allergies and how to deal with the ever present allergy to PCN.
Dr. Kay is available for virtual consultations and to give Grand Rounds talks on this topic anytime. You can reach him at jkay11@mac.com.
CME: Link
Random Recs
Morning Jed
In episode, 274 at approximately time, 13:45. You discuss the changes in serum triptase values. You provided an example whereby initially the value is 9 and then at 24 hours it is 2. Can you clarify this statement? You indicated thst this would be indicative of an anaphylactic reaction. However, your example demonstrates a reduction in triptase value rather than an increase in triptase. According to the guests, a doubling plus 1.2. Regardless of the value being above, the laboratory normal would be indicative of an anaphylactic reaction.
Can you clarify as this part of the discussion raised an eyebrow.
Cheers!
Hi David,
The point here is that 24h later the tryptase should have returned to baseline. So if it is 2 24h after the event, and it was 9 during the event, then that value of 9 is so much higher than baseline that it is indicative of anaphylaxis even though it isn’t above the threshold of 9-11 that is usually used. I hope that helps!