Reactions Weekly

, Volume 1738, Issue 1, pp 186–186 | Cite as

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Anaphylaxis and lack of efficacy: 3 case reports
Case report
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An event is serious (based on the ICH definition) when the patient outcome is:

  • * death

  • * life-threatening

  • * hospitalisation

  • * disability

  • * congenital anomaly

  • * other medically important event

In a case report, 3 elderly men aged 75−84 years were described, who developed anaphylaxis during treatment with protamine sulfate [Protamine] alone, insulin [Humulin] or insulin-suspension-isophane [isophane insulin, Insulatard InnoLet] containing protamine sulfate as an ingredient used for heparin reversal. Additionally, one man had lack of efficacy during anaphylaxis treatment with calcium chloride, epinephrine and metaraminol [not all routes, dosages and time to reactions onset stated].

Case.1: The 78-year-old man developed anaphylaxis during treatment with protamine sulfate alone, and insulin-containing protamine sulfate as an ingredient. The diabetic man underwent elective coronary artery bypass grafting (CABG). While receiving insulin containing protamine sulfate as an...


  1. Valchanov K, et al. Three Cases of Anaphylaxis to Protamine: Management of Anticoagulation Reversal. Journal of Cardiothoracic and Vascular Anesthesia 33: 482-486, No. 2, Feb 2019. Available from: URL: - United Kingdom

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© Springer Nature Switzerland AG 2019

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