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Adverse reactions to patent blue V dye – The NEW START and ALMANAC experience

Barthelmes, Ludger, Goyal, Amit, Newcombe, Robert Gordon, McNeill, F. and Mansel, Robert Edward 2010. Adverse reactions to patent blue V dye – The NEW START and ALMANAC experience. European Journal of Surgical Oncology (EJSO) 36 (4) , pp. 399-403. 10.1016/j.ejso.2009.10.007

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Background Blue dye with or without isotope has been widely used to identify the sentinel lymph node(s) in breast cancer. Patent blue V is used in the UK while its isomer isosulfan blue is used in the US. The allergic potential of isosulfan blue is well documented (1.4% adverse reactions) but that of patent blue V is less clearly defined. Methods In this paper we review the adverse reactions of patent blue V in 7,917 patients who participated in the NEW START training programme and the ALMANAC trial. All patients underwent sentinel lymph node biopsy for breast carcinoma using patent blue V in combination with 99mTc-albumin colloid. Results In total, 72 of 7,917 (0.9%) patients experienced adverse reactions : non-allergic reactions were observed in 4 (0.05%) patients, 23 (0.3%) patients had minor grade I allergic skin reactions (urticaria, blue hives, pruritis, or generalised rash) and 16 (0.2%) had grade II reactions (transient hypotension/bronchospasm/laryngospasm). Severe Grade III reactions (severe hypotension requiring vasopressor support and/or change/abandoning of planned procedure and/or HDU/ITU admission) were noted in 5 (0.06%) patients. The type of adverse reaction was not specified in 24 (0.3%) patients. No mortality was recorded. Conclusion The allergic potential of patent blue V dye compares favourably with isosulfan blue however both the surgeon and anaesthetist need to be alert to the risk of allergic reactions.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Uncontrolled Keywords: Allergy; Anaphylaxis; Breast cancer; Isosulfan blue; Patent blue V; Sentinel lymph node biopsy
Publisher: Elsevier
ISSN: 0748-7983
Last Modified: 10 Oct 2017 14:07

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