Un patient de 72 ans devait bénéficier d'un triple pontage aortocoronarien pour des lésions tritronculaires sévères. Un choc anaphylactique survenait peu de temps après l'induction anesthésique et l'injection d'acide tranexamique (Exacyl^®). Les résultats des explorations allergologiques (tests cutanés, test d'histaminolibération in vitro) permettaient de conclure au premier cas de choc anaphylactique à l'acide tranexamique. Une nouvelle intervention, conservant exactement le même protocole anesthésique et en l'absence d'Exacyl^® a pu avoir lieu dans de bonnes conditions.

A 72-year-old male patient was scheduled for coronary artery bypass graft surgery because of severe three-vessel disease. Induction of anaesthesia was uneventful. Following bolus infusion of tranexamic acid (Exacyl^®), the patient presented clinical signs consistent with anaphylactic shock. Surgery was postponed and the patient recovered without sequaelae. Allergological investigations (cutaneous tests, serum IgE concentrations, in vitro histamine-release tests) suggest that this is the first reported case of anaphylactic shock to tranexamic acid. Several weeks later, the patient underwent surgery with a similar anaesthetic regimen and the clinical course was uneventful.