Anaphylactic shock induced by polygeline misdiagnosed as pulmonary embolism

A 51-year-old female patient underwent resection of lymphatic cyst because of the infection of her pelvic lymphatic cyst after the cervical cancer operation. After the operation, the patient was given sequentially IV infusions of haemocoagulase agkistrodon for injection 2 units (dissolved in 0.9% sodium chloride injection), 10% potassium chloride injection 15 ml (added to 10% glucose injection 500 ml), and polygeline injection 500 ml. When about 100 ml of polygeline injection was infused, the patient suddenly lost consciousness, and her breath rate was 10 times/min, heart rate was 120 beats/min, blood pressure was 70/50 mmHg, and oxygen saturation was 0.70. Pulmonary embolism was considered and respiratory stimulants, hypertensors, and heparin were given, but the patient′s symptoms continued to worsen and her blood pressure dropped to 0. After 28 minutes of the rescue, allergic shock caused by polygelatin peptide injection was considered because of the flushing of the patient′s skin. The polygeline injection was stopped immediately, and then antianaphylaxis and antishock treatments were given. The patient′sblood pressure began to recover but remained unstable. Echocardiography showed more pericardial effusion than before the operation. Pericardiocentesis was urgently implemented, draining about 80 ml of effusion, and the drainage tube was indwelled. Antianaphylaxis and antishock treatments were continued. About 50 minutes later, the patient regained consciousness. And about 11 hours later, her blood pressure was 135/85 mmHg, breath rate was 18/min, heart rate was 100 beats/min, and oxygen saturation was 1.00. Key words: Polygeline; Anaphylaxis; Shock