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Allergic reaction to a bovine dural substitute following spinal cord untethering. Case report. J Neurosurg Pediatr 2008 Feb;1(2):167-9

Date

03/21/2008

Pubmed ID

18352792

DOI

10.3171/PED/2008/1/2/167

Scopus ID

2-s2.0-40849142589   17 Citations

Abstract

Bovine tissues are now routinely used for dural closure in cranial and spinal surgery. The authors report the case of an 18-year-old woman with a history of myelomeningocele who had symptoms of tethered cord syndrome and presented to a regional hospital. At that hospital she underwent a cord untethering procedure. The spinal dura was closed with Durepair, a dural substitute derived from fetal bovine skin. Her postoperative course was complicated by a cerebrospinal fluid leak that was surgically repaired. Following this, she developed erythroderma, intermittent fevers, eosinophilia, and marked elevation in serum immunoglobulin E. She was then transferred to the authors' institution. A skin antigen test to beef was administered, which revealed a positive reaction. A radioallergosorbent test to beef also yielded positive results. She was taken to the operating room for removal of the bovine graft due to concern for an allergic reaction to the graft. The graft material showed evidence of eosinophilic infiltration. Her clinical symptoms and laboratory values all improved after surgery. To the authors' knowledge this is the first reported case of an allergic reaction to bovine-based dural substitutes.

Author List

Foy AB, Giannini C, Raffel C

Author

Andrew Foy MD Associate Professor in the Neurosurgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Animals
Biocompatible Materials
Cattle
Dermatitis, Exfoliative
Dura Mater
Exanthema
Female
Follow-Up Studies
Humans
Hypersensitivity
Meningomyelocele
Postoperative Complications
Skin Transplantation
Spinal Cord
Surgical Wound Dehiscence
Transplantation, Heterologous