Severe anaphylactic shock with methylene blue instillation

Anesth Analg. 2005 Jul;101(1):149-50, table of contents. doi: 10.1213/01.ANE.0000153497.60047.80.


We report a documented severe immunoglobulin E-mediated hypersensitivity reaction associated with use of 1% methylene blue for detection of tubal permeability occurring during general anesthesia. Clinical symptoms, biological assessment results, and cutaneous test positivity confirmed an anaphylactic reaction to methylene blue. This case report confirms the need for systematic allergological investigation of all drugs and substances administered during the perioperative period in the event of a hypersensitivity reaction occurring during anesthesia. Anesthesiologists should be aware of the possibility of hypersensitivity reactions involving any drug or substance used during surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anaphylaxis / etiology*
  • Anesthesia, General
  • Fallopian Tube Diseases / diagnosis
  • Fallopian Tube Diseases / surgery
  • Female
  • Gynecologic Surgical Procedures
  • Histamine / blood
  • Histamine Release / drug effects
  • Humans
  • Immunoglobulin E / immunology
  • Leukocytes / drug effects
  • Leukocytes / metabolism
  • Methylene Blue / adverse effects*
  • Skin Tests
  • Urticaria / etiology


  • Immunoglobulin E
  • Histamine
  • Methylene Blue