Вісник проблем біології і медицини, Випуск 1 (172)
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Перегляд Вісник проблем біології і медицини, Випуск 1 (172) за Ключові слова "anaphylaxis"
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Документ Anaphylaxis to vascular injection of tomohexol in a patient from the risk group (a clinical case)(Полтавський державний медичний університет, 2024) Nikolenko, D. E.; Prylutskyi, O. K.; Zadvornova, A. P.; Ніколенко, Дмитро Євгенійович; Прилуцький, Олексій Костянтинович; Задворнова, Анна ПетрівнаElucidation of the patency of the arteries of internal organs affected by atherosclerosis by the introduction of an X-ray contrast agent (XCR) – tomohexol, improved the quality of diagnosis of this pathology. At the same time, the surgical procedure became problematic due to side effects on the body in patients with sensitivity to iodine. At the same time, in the clinic, such cases, sometimes with a fatal outcome, are from 1.5 to 35%, depending on the age of the patient, overdose of yRKR, complex of diseases, place of residence and even speed of administration. An important role in the verification of the side effect and the cause of its occurrence is assigned to a thorough investigation of the patient's life history to identify sensitivity to iodine from the problematic region of residence. This is necessary for clinical and pathomorphological diagnosis of IgE reagin antibodies. This work presents a retrospective analysis of the patho-anatomical protocol of an autopsy, the study of micropreparations of the internal organs of a deceased elderly patient from systemic anaphylaxis type I. A confirmed complex of heart diseases (hypertensive disease, ischemic heart disease), complicated atherosclerosis of the arteries of the lower extremities, as well as coronary, renal, and cerebral arteries. In this work, it was found that the deceased patient from general anaphylaxis type I had signs of individual exposure to the allergen – iodine, as an antigen, against the background of sensitization of IgE reagin antibodies on lung mast cells and myocardium. This is confirmed pathomorphologically (histochemically) by severe damage to vital organs – lungs, myocardium, brain and others as a result of degranulation by mast cells of histamine, a slowly reacting substance in the form of an asphyxic course of anaphylaxis (bronchiolospasm, hypersecretion of mucus), as well as hemodynamic disorders in the form of collapse of arterioles, non-cardiogenic edema of organ tissue, Minakov's spots under the endocardium, "empty heart", "muscular death of the heart" and venous edema of the brain with wedging in the large occipital foramen. A mixed goiter was detected, which was clinically indeterminate. The research will interest therapists, immunologists, vascular surgeons, and pathologists.