SUDDEN FATAL ANAPHYLACTIC REACTION TO HUMAN ALBUMIN INFUSION IN A PATIENT WITH RHEUMATIC HEART DISEASE: A CASE REPORT

Abstract

Human serum albumin (HSA) is widely used to manage critical conditions that need fine fluid homeostasis, such as hypoalbuminemia, cirrhosis, and heart failure. While generally safe, rare cases of hypersensitivity and anaphylaxis have been reported. We report a case of fatal anaphylaxis following HSA infusion in a 49-year-old woman with rheumatic heart disease, acute decompensated heart failure, and congestive hepatopathy. After initial infusion, she developed urticaria, abdominal pain, diarrhea, dyspnea, and hypotension, consistent with anaphylaxis. Despite stopping the infusion and treatment, a second administration led to a more severe reaction, resulting in cardiac arrest and death. Anaphylaxis related to albumin is extremely rare and can be difficult to diagnose in patients with underlying conditions. The mechanisms are not fully understood, but they may involve both IgE-mediated and non-IgE-mediated pathways. Treatment follows standard anaphylaxis protocols, with epinephrine as first-line therapy. No standardized protocols exist for albumin allergy, emphasizing the need for heightened clinical awareness. This case highlights the potential for fatal anaphylactic reactions to albumin, especially upon re-exposure, and underscores the importance of vigilance and avoidance of repeat administration after initial hypersensitivity