<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0871-9721</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Imunoalergologia]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Port Imunoalergologia]]></abbrev-journal-title>
<issn>0871-9721</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Alergologia e Imunologia Clínica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0871-97212022000100051</article-id>
<article-id pub-id-type="doi">10.32932/rpia.2022.03.078</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Cisatracúrio - Um relaxante neuromuscular &#8220;seguro&#8221;?]]></article-title>
<article-title xml:lang="en"><![CDATA[Cisatracurium - A &#8220;safe&#8221; neuromuscular blocking agent?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gonçalves]]></surname>
<given-names><![CDATA[Tânia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pita]]></surname>
<given-names><![CDATA[Joana Sofia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinto]]></surname>
<given-names><![CDATA[Nicole]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ornelas]]></surname>
<given-names><![CDATA[Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinto]]></surname>
<given-names><![CDATA[Paula Leiria]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar e Universitário de Lisboa Central EPE Hospital Dona Estefânia Serviço de Imunoalergologia]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro Hospitalar Médio Tejo Unidade de Imunoalergologia ]]></institution>
<addr-line><![CDATA[Torres Novas ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Nova Medical School Integrated Pathophysiological Mechanisms Research Group CEDOC]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>03</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>03</month>
<year>2022</year>
</pub-date>
<volume>30</volume>
<numero>1</numero>
<fpage>51</fpage>
<lpage>56</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0871-97212022000100051&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0871-97212022000100051&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0871-97212022000100051&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO Os agentes anestésicos representam uma causa importante de anafilaxia a fármacos, sendo os relaxantes neuromusculares (RNM) dos principais responsáveis pelos casos de anafilaxia perioperatória. O cisatracúrio é o RNM mais recente, sendo um estereoisómero do atracúrio que se acreditava não ter potencial de libertação de histamina e, consequentemente, causar menos reações alérgicas do que os outros RNM. No entanto, têm sido relatados vários casos de reação anafilática grave após administração de cisatracúrio, não existindo, do nosso conhecimento, registo na literatura de nenhum em Portugal. As autoras apresentam dois casos de anafilaxia perioperatória grave (grau 4 na escala de Ring &amp; Messmer) com paragem cardiorrespiratória. Na investigação alergológica foram realizados testes cutâneos, cujos intradérmicos se revelaram positivos para o cisatracúrio (1:100) em ambos os doentes. É importante alertar que este RNM não será tão desprovido de potencial alergénico como previamente pensado e esse facto deve ser considerado na investigação de uma reação alérgica que ocorra durante a indução anestésica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Anesthetic agents are an important cause of drug anaphylaxis, with neuromuscular blocking agents (NMBA) being a common cause of intraoperative anaphylaxis. Cisatracurium, a stereoisomer of atracurium, is the most recent NMBA, which was believed to have no histamine-releasing potential, and therefore, cause less allergic reactions than other NMBA. Although there have been several cases of severe anaphylactic reactions to cisatracurium reported worldwide, there are no known published cases in Portugal, to the best of our knowledge. The authors present two cases of severe perioperative anaphylaxis (grade 4 according to Ring &amp; Messmer Classification) with cardiorespiratory arrest. In the allergological work-up, a positive intradermal skin test for cisatracurium (1: 100) was found in both patients. It is important to emphasize that this NMBA is not exempt of allergenic potential as previously thought. Thus, it should be taken into account when assessing an allergic reaction that occurred during anesthetic induction.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Alergia]]></kwd>
<kwd lng="pt"><![CDATA[anafilaxia]]></kwd>
<kwd lng="pt"><![CDATA[anestésicos]]></kwd>
<kwd lng="pt"><![CDATA[cisatracúrio]]></kwd>
<kwd lng="pt"><![CDATA[fármacos]]></kwd>
<kwd lng="pt"><![CDATA[hipersensibilidade]]></kwd>
<kwd lng="pt"><![CDATA[perioperato&#769;rio]]></kwd>
<kwd lng="pt"><![CDATA[relaxantes neuromusculares]]></kwd>
<kwd lng="en"><![CDATA[Allergy]]></kwd>
<kwd lng="en"><![CDATA[anaphylaxis]]></kwd>
<kwd lng="en"><![CDATA[anesthetic agents]]></kwd>
<kwd lng="en"><![CDATA[cisatracurium]]></kwd>
<kwd lng="en"><![CDATA[drugs]]></kwd>
<kwd lng="en"><![CDATA[hypersensitivity]]></kwd>
<kwd lng="en"><![CDATA[perioperative]]></kwd>
<kwd lng="en"><![CDATA[neuromuscular blocking agents]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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