Abstract
Human fibrinogen (FIB) has been clinically proven to be considerably effective for the treatment of postoperative bleeding, with reported cases of allergic reactions to human FIB being rare. Here, we report a case of an anaphylactic shock in 27-year-old patients with rheumatic heart valve disease who received a human FIB infusion during mitral valve replacement, aortic valve replacement, and tricuspid valve-shaping surgery. The patients showed generalised profuse sweating, a barely noticeable skin rash, faint pulse, systolic pressure < 50 mmHg, and a heart rate of 71 beats/min. We share insights from a case of severe allergy to human FIB infusion during cardiac surgery, through which we have gained experience in the processes of diagnosing and treating. This report aims to provide a preliminary summary of the characteristics of this case to serve as a reference for fellow clinicians.
Anaphylactic reactions are potentially serious systemic responses, either immunologic or nonimmunologic, that are typically rapid in onset, of variable severity, responsive to the timely administration of epinephrine, and rarely cause death [1]. Severe anaphylaxis is characterised by the compromise of breathing and/or circulation and most often, but not always, progresses from and is preceded by milder signs/symptoms [2]. There is some genetic tendency and individual distinction involved in these reactions [3]. Human fibrinogen (FIB) preparations are derived from the plasma of healthy individuals through a process that includes separation, purification, viral inactivation, and lyophilisation. The infusion of human FIB corrects hypofibrinogenemia and improves coagulation function disorder [4]. However, sporadic instances of adverse allergic reactions to it have been documented. Detailed below is such a case, marked by a severe allergic reaction precipitated by human FIB infusion.