Intraoperative anaphylaxis due to gelofusine in a patient undergoing intramedullary nailing of the femur: a case report

BACKGROUND: Although uncommon, anaphylaxis due to a colloid plasma expander can occur peri-operatively CASE PRESENTATION: We present a case of an intra-operative cardiac arrest in a 72 year old Caucasian male patient who underwent prophylactic intramedullary nailing for a proximal femoral metastasis from prostate cancer. The patient was resuscitated successfully and the procedure was completed uneventfully. Elevated serum tryptase levels confirmed the diagnosis of an anaphylactic reaction and positive allergy skin prick testing identified gelofusine as the causative agent. CONCLUSION: A high index of suspicion, prompt diagnosis and rapid institution of treatment are essential for a safe outcome following such reactions. To our knowledge, this is the first published report of such a severe reaction to gelofusine infusion that occurs during an orthopaedic procedure.