A Case of Post Operative Anaphylactic Shock Induced by Cross Reaction between Gabexate Mesilate and Nafamostat Mesilate

Akihiro Oda, Takeyuki Misawa and Katsuhiko Yanaga

Department of Surgery, Jikei University School of Medicine

We report a case of postoperative anaphylactic shock induced by a cross-reaction between gabexate mesilate (=FOY) and nafamostat mesilate (=FUT). A 64 year old man underwent pancreatoduodenectomy under a diagnosis of cancer of the papilla of Vater. He underwent postoperative infusion of FUT, 20 mg. Immediately following the infusion, he suffered a whole-body rash and shock with edema. He recovered consciousness after oxygen therapy and steroid infusion. One hour later, respiration and circulation had returned to normal, despite increased eosinophilic leukocytes and abnormally high IgE antibody for FUT and FOY. Also, he had underwent infusion of FOY, second times, when he had got at the operation of laparoscopic cholecystectomy, which took place one year previously, and when he taken ERCP before the operation of pancreatoduodenectomy. We concluded that there were some possibility of a cross-reaction between FUT and FOY based on the similarity of an antigenic determinant, i.e., FOY sensitization and anaphylactic response to FUT

Key words
nafemostat mesilate, gabexate mesilate, anaphylactic shock

Reprint requests
Akihiro Oda Department of Surgery, Jikei University, School of Medicine
3-25-8 Nisisinbasi, Minato-ku, 105-8461 JAPAN

Accepted
September 27, 2006

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