1. Introduction
Post-anaphylactic mast cell anergy defines a state of mast cell
unresponsiveness following massive activation. It is manifested by a
loss of cutaneous reactivity to skin tests, and has been described in
several series1, 2 and clinical
cases3, 4, 5, 6 in the context of anaphylaxis to
hymenoptera venoms and perioperative anaphylaxis. Current
recommendations by allergology societies indicate diagnostic skin
testing between 4 and 8 weeks7, 8 after a severe
hypersensitivity reaction to avoid false negative results. The
mechanisms involved in this phenomenon are incompletely understood and
implicate mast cells mediators depletion.
We report a case of mast cell anergy which enabled a patient to tolerate
accidental reintroduction of amoxicillin, despite having presented with
intraoperative anaphylactic shock to amoxicillin 3 days earlier.