CASE REPORTS Hormonal and Hemodynamic Profile

ANAPHYLACTIC REACTIONS have been described frequently in the medical literature." 2 It has been established, largely by studies with in vitro models, that anaphylaxis is caused by an IGE-mediated degranulation of tissue mast cells and basophils, with discharge of histamine, prostaglandins and other substances into the surrounding circulation. The profile of hemodynamic and biochemical change in such reactions, however, has not been fully documented in man, particularly as to whether catecholamines are released in response to increases in plasma histamine levels. A recent experience in which a patient sustained an anaphylactic reaction to the muscle relaxant succinylcholine provided an opportunity to correlate changes in hemodynamics with alterations in plasma histamine and catecholamine levels during anaphylaxis. Our findings suggest that, in addition to the direct effects of histamine on the cardiovascular system, the induced sympathoadrenal response may be an important component of the pathophysiology of anaphylaxis.