Introduction:

Sugammadex is a cyclodextrin that reverses neuromuscular blockade, especially of rocuronium. The occurrence of anaphylaxis produced by its use is of 1:1000 and 1:20000; it is observed mainly in subjects of Asian origin.

Case report:

A 9-year-old boy of Asian origin who, after the administration of sugammadex, immediately manifested an episode of anaphylaxis, which was reverted by using adrenaline and antihistamines. The serum tryptase at two hours was 27.7 μg/L; at 6 weeks, it was 3 μ/L. The sugammadex 100 mg/mL skin test was positive. The basophil activation test was positive with sugammadex 20 mg/mL.

Conclusion:

The temporal relationship between the administration of the drug, the clinical manifestations, the elevation of tryptase, and the diagnostic tests performed, disclosed the episode of anaphylaxis associated with hypersensitivity to sugammadex.