Nikolenko D. E., Prylutskyi O. K., Zadvornova A. P.

ANAPHYLAXIS TO VASCULAR INJECTION OF TOMOHEXOL IN A PATIENT FROM THE RISK GROUP (A CLINICAL CASE)

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About the author:

Nikolenko D. E., Prylutskyi O. K., Zadvornova A. P.

Heading:

PATHOMORPHOLOGY

Type of article:

Scientific article

Annotation:

Anaphylaxis is a state of hypersensitivity and decreased resistance to antigenic effects. The formation of IgE reagin antibodies by plasmocytes with their fixation on the surface of tissue basophils (mastocytes) is the immunological stage and the essence of human sensitisation. The interaction of the antigen with IgE (immunological stage) is called anaphylaxis. The release of primary mediators of anaphylactic reaction in the first minutes as a result of mast cell degranulation is the pathochemical stage of type I anaphylaxis. Degranulation products act directly on the target smooth muscle cells. It provokes a systemic haemocirculatory disorder and the progression of life-threatening conditions of internal organs (pathophysiological stage). The study aims to analyse the side effects of tomohexol in an elderly patient with multiorgan pathology when administered intra-arterially for the diagnosis of patency of lower limb vessels with critical ischaemia. The material is the archival documentation of the autopsy case. A retrospective analysis of the patient's clinical examination, autopsy report and microsections of internal organs stained with hematoxylin and eosin; histochemically – with Mayer's toluidine blue (to determine the activity of mast cells in organ tissue); HBFP (hematoxylin basic fuchsin-picric acid) – to identify damage to cardiac muscle cells was conducted. It was established that the deceased with general atherosclerosis, subcompensated hypertension, chronic coronary heart disease, obesity, mixed goiter, nephrolithiasis, and liver fatty disease had a type I systemic anaphylaxis to repeated intra-arterial injection of tomohexol in an acceptable dose into the blood supply vessels of the lower extremity and coronary arteries. This reaction was based on the body's individual immunity to iodine-containing thyroid hormone. Vital organs underwent the greatest morphological and functional changes: lungs, heart, and brain due to severe haemomicrocirculation disorder, non-cardiogenic oedema, sudden insufficiency of blood oxygenation, stop of blood flow in the heart, and nephrotic syndrome. The leading role of an individual approach in examining the patient before the study of blood vessels with tomohexol has been established.

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Publication of the article:

«Bulletin of problems biology and medicine», 2024 Issue 1, 172, 450-461 pages, index UDC 616.072:612.017:616-056.3:615.4

DOI:

10.29254/2077-4214-2024-1-172-450-461