An anaphylactic reaction to protamine in a patient allergic to fish

Abstract

Protamine sulfate, a low molecular weight protein found in the sperm of certain fish, is widely used as a heparin antagonist. Although hypotension can occur with rapid administration of high doses, slow rates of infusion have little effect on blood pressure. Severe anaphylactic reactions to protamine sulfate have been reported, although these are rare. A patient who was allergic to fish and developed a severe anaphylactic reaction after receiving protamine sulfate is described.