Introduction: Rapid desensitization allows secure administration of a drug and is indicated when there is no therapeutic alternative.
Case Report: We report a 49-year-old patient who presented with a hypersensitivity reaction following an infusion of rituximab (375mg/m(2)) in the context of a Castleman's syndrome. After a clinical flare (splenomegaly, adenopathies) despite treatment with tocilizumab, anakinra and valganciclovir, the reintroduction of rituximab was decided, according to the rapid desensitization protocol. Four full dose desensitizations were successfully performed allowing immediate clinical improvement (apyrexia, loss of sweating and lymphadenopathy, splenomegaly partial regression) and biological (negativation of HHV8 viral load, and disappearance of neutropenia, anemia and thrombocytopenia).
Conclusion: Rapid desensitization is a promising method for the pursuit of rituximab therapy after a hypersensitivity reaction and should be considered in patients with no acceptable therapeutic alternative.
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http://dx.doi.org/10.1016/j.revmed.2015.08.011 | DOI Listing |
Acta Dermatovenerol Croat
November 2024
Vesna Vukičević Lazarević, MD Special Hospital for Pulmonary Diseases, Rockefellerova 3, 10000 Zagreb, Croatia;
Pathophysiologically, drug hypersensitive reactions (DHRs) are classified into four types: type I, immediate reactions, and types II, III, and IV, non-immediate reactions. They are further categorized as severe or non-severe based on clinical severity. Genetic predisposition and viral reactivation are cofactors of severe DHR type IV.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Paediatrics, Nephrology and Hypertension, Medical University of Gdansk, 80-210 Gdansk, Poland.
: Idiopathic nephrotic syndrome (INS) is the most common cause of nephrotic syndrome in children. A hallmark of the disease is the rapid remission of proteinuria following a high dose of steroids. Recurrent disease or steroid dependence are common, leading to a high steroid burden and the introduction of steroid sparing therapy.
View Article and Find Full Text PDFOrphanet J Rare Dis
December 2024
Post Graduate School in Allergology and Internal Medicine "Guido Baccelli", Department of Precision and Regenerative Medicine and Ionian Area-(DiMePRe-J), School of Medicine, Aldo Moro University of Bari, Bari, 70124, Italy.
Background: Mucopolysaccharidosis (MPS) type 1 S and type 2 are rare lysosomal storage disorders characterized by impaired enzyme production, resulting in glycosaminoglycans accumulation within lysosomes. Enzyme Replacement Therapy (ERT) with laronidase and idursulfase are first line treatments, respectively. However, infusion-related hypersensitivity reactions (HR) may lead to ERT discontinuation.
View Article and Find Full Text PDFFront Allergy
December 2024
Allergy Department, Castellon University General Hospital, Castellon de la Plana, Spain.
Background: Hypersensitivity reactions to chemotherapy disrupt treatment schedules and compromise patient outcomes. Rapid Drug Desensitization (RDD) enables patients to tolerate future treatments after an allergy workup. However, Same-Day Desensitization (SDD) is a novel approach that capitalizes on RDD to allow the continuation of chemotherapy on the same day as the index reaction, preventing treatment delays.
View Article and Find Full Text PDFbioRxiv
December 2024
Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, Connecticut, USA.
Calcium (Ca) ions affect nearly all aspects of biology. Excessive Ca entry is cytotoxic and Ca-mobilizing receptors have evolved diverse mechanisms for tight regulation that often include Calmodulin (CaM). TRPA1, an essential Ca-permeable ion channel involved in pain signaling and inflammation, exhibits complex Ca regulation with initial channel potentiation followed by rapid desensitization.
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