Feeling blue, going green and finding other attractive alternatives: a case of biphasic anaphylaxis to patent blue and a literature review of alternative sentinel node localisation methods

BMJ Case Rep. 2015 Dec 15;2015:bcr2015213107. doi: 10.1136/bcr-2015-213107.


Patent blue dye is used for sentinel lymph node localisation in order to stage the axilla in patients with breast cancer. Patent blue is one of the most common dyes used across the UK, however, the incidence of adverse effects seems to be increasing. This case highlights our experience of a biphasic anaphylactic reaction to patent blue dye, and we conduct a brief literature review of alternative and more novel methods to adequately visualise the lymphatics for sentinel lymph node biopsy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anaphylaxis / chemically induced*
  • Anaphylaxis / drug therapy
  • Anti-Inflammatory Agents / therapeutic use
  • Breast Neoplasms / pathology
  • Coloring Agents / adverse effects*
  • Drug Hypersensitivity / drug therapy
  • Drug Hypersensitivity / etiology*
  • Female
  • Humans
  • Hydrocortisone / therapeutic use
  • Lymph Nodes / pathology
  • Sentinel Lymph Node Biopsy / methods*
  • Treatment Outcome


  • Anti-Inflammatory Agents
  • Coloring Agents
  • Hydrocortisone