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[Severe asthmatic crisis during general anesthesia in a patient with IgG4 related disease].

Masui. The Japanese journal of anesthesiology (2014-05-03)
Machika Moriya, Shinya Oda, Masaki Nakane, Kaneyuki Kawamae
ABSTRACT

We experienced severe asthmatic crisis during general anesthesia in a 45-year-old man with IgG4-related disease, COPD and athma undergoing removal of submandibular gland. The ventilatiory failure was caused by the stimulation of the operation, sputum, and neostigmine. His serum IgG4 level was extremely high. IgG4 related disease is a recently emerging entity characterized by a diffuse or mass forming inflammatory reaction rich in IgG4-positive plasma cells associated with fibrosclerosis and obliterative phlebitis. It is associated with an elevated serum level of IgG4 and an allergic disease. We must be careful in perioperative management of the patients with IgG4-related disease because general anesthesia can induce asthmatic crisis.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Neostigmine bromide, ≥98% (HPLC and titration), powder
Sigma-Aldrich
Neostigmine methyl sulfate
Neostigmine bromide, European Pharmacopoeia (EP) Reference Standard
Neostigmine methyl sulfate, European Pharmacopoeia (EP) Reference Standard

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