# Unraveling the Cause of Perioperative Anaphylaxis: The Role of Patent Blue Dye and Midazolam

## TL;DR

A patient experienced anaphylaxis due to allergies to midazolam and patent blue dye, highlighting the importance of identifying multiple drug allergies and the role of allergists.

## Contribution

This case highlights the rare occurrence of dual drug allergy and the potential for synergistic effects in anaphylaxis.

## Key findings

- The patient was allergic to both midazolam and patent blue dye.
- The immunoallergology team played a crucial role in diagnosing the anaphylaxis and identifying the causative agents.

## Abstract

We report a case of anaphylactic shock in a patient scheduled for a left mastectomy with sentinel lymph node biopsy who was found to be allergic to both midazolam and patent blue dye. This case underscores the occurrence of dual drug allergy in a single patient, with the possibility of synergistic effects that cannot be ruled out. Additionally, it emphasizes the vital role of the immunoallergology team in suspected anaphylaxis cases, as their specialized knowledge is crucial for establishing an accurate diagnosis and identifying the causative agents.