[Allergic reaction to patent blue dye in breast surgery - case report]

Blue Wheals and Blue Angioedema Induced by Blue Dyes: A Systematic Review

BACKGROUND

Blue wheals and blue angioedema, the adverse reactions to blue dye injections with or without anaphylaxis, are poorly defined.

OBJECTIVE

The objective is to review the characteristics (ie, sex and age at onset, interval between blue dye injection and symptom onset, clinical manifestations, duration of blue wheals or angioedema), natural courses, and treatments of blue dye adverse reactions.

METHODS

A review of the articles published through July 2021 was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations.

RESULTS

Across 523 patients (175 studies) with any adverse reactions to blue dye injections, wheals, angioedema, or both occurred in 193 patients (36.9%). Of these 193 patients, 68 patients (35.2%) developed blue wheals or angioedema, 118 (61.1%) had ordinary wheals or angioedema (nonbluish), and 7 had both (3.6%). We reviewed 169 patients with available data (99 with ordinary lesions and 70 with blue lesions). Patent blue violet had the highest rate of inducing blue wheals or angioedema (odds ratio 4.9). Almost half of the patients with blue wheals or angioedema developed systemic symptoms; and of those with systemic symptoms, all except 1 progressed to anaphylaxis. On-demand treatments with antihistamines, corticosteroids, and epinephrine were commonly used and effective.

CONCLUSIONS

Using blue dyes can lead to blue wheals or angioedema and systemic reactions. In patients with a history of a severe allergic reaction to a blue dye, repeat administration of a blue dye should be used only after carefully weighing all the risks and benefits.

Insight into Green Extraction for Roselle as a Source of Natural Red Pigments: A Review

Roselle (Hibiscus sabdariffa L.) is a source of anthocyanins as red pigments that is extensively farmed in tropical and subtropical regions, including Indonesia, Malaysia, China, Thailand, Egypt, Mexico, and West India. The roselle plant contains a variety of nutrients, including anthocyanins, organic acids, pectin, etc. Due to the toxicity and combustibility of the solvents, traditional extraction methods for these compounds are restricted. Obtaining pure extracts is typically a lengthy procedure requiring many processes. Supercritical carbon dioxide (ScCO₂) extraction as a green technology is rapidly improving and extending its application domains. The advantages of this method are zero waste production, quicker extraction times, and reduced solvent consumption. The ScCO₂ extraction of natural pigments has great promise in food, pharmaceuticals, cosmetics, and textiles, among other uses. The ScCO₂ technique for natural pigments may also be advantageous in a variety of other contexts. Due to their minimal environmental risk, the high-quality red pigments of roselle rich in anthocyanins extracted using ScCO₂ extraction have a high sustainability potential. Therefore, the objective of this review is to increase knowledge related to the natural colorant of roselle as a substitute for chemically manufactured colorants using ScCO₂ as a green method. This article covers ScCO₂ extraction, particularly as it relates to the optimization of pigments that promote health. This article focuses on the high extraction efficiency of ScCO₂ extraction. Natural colorants extracted via ScCO₂ are regarded as safe compounds, especially for human consumption, such as novel functional food additives and textile and pharmaceutical colors.

Red Tomato Products as an Alternative to Reduce Synthetic Dyes in the Food Industry: A Review

Most dyes used in the food industry are synthetic and can be a health hazard. Red tomato may serve as a natural alternative dye to replace synthetic colorants. This study aimed to review the literature on the addition of red tomato products (powder tomato, paste, freeze-dried, tomato peel powder, tomato pomace) to reduce the usage of synthetic dyes in the food industry. Red tomato products have been used as coloring in pasta, bologna, sausages, cookies, crackers, macaroons, hamburgers, breads, muffins, cheeses, and nuggets. The trans-cis isomerization of lycopene by oxidative processes directly affects the color of the pigment. The lycopene contained in tomato has antioxidant activity and could reduce or eliminate other oxidants and/or synthetic preservatives in food. Moreover, tomatoes in foods have high sensory scores, nutritional appeal, and marketing potential. However, its use as a food colorant has been not extensively explored. Therefore, further studies are still required, especially on the stability of carotenoids in tomatoes used in processed foods.

Anaphylaxis to patent blue dye in a 17-year-old boy

Patent blue V dye (PBV) is frequently used as a perioperative drug for lymphangiography, as well as a food additive. Hypersensitivity to PBV is poorly documented in adults and had not been previously described in children. The diagnosis of PBV allergy depends on corroboration of history consistent with an IgE-mediated reaction and confirmatory skin tests. We present in this paper a paediatric case of PBV anaphylaxis and of biphasic reaction that exemplifies the challenges involved in diagnosing and managing this rare but potentially life-threatening allergic reaction.