Introduction: Rituximab is an Anti-CD20 chimeric monoclonal antibody, being the treatment of lymphoproliferative diseases and rheumatological disorders; hypersensitivity reactions (HRS) are associated with infusion, cytokine release, type I (IgE/non-IgE), mixed, type III and IV. Desensitization seeks to induce tem- porary tolerance, decreasing the probability of clinical manifestations through gradual administration of the total dose of the drug, being target cells of the procedure, basophils, and mast cells, preventing their activation.
Case Report: The objective is to present a personalized desensitization protocol in a 36-year-old female patient with systemic lupus erythematosus (SLE) pre- viously treated with rituximab in 2019, 4 doses, presenting during the fourth administration, after 10 minutes, dyspnea, feeling foreign body in the pharynx, chest pain, angioedema, and neurological alteration. Requiring new administration of rituximab due to persistent proteinuria secondary to SLE. After performing skin tests (negative), a 13-step desensitization scheme was performed with 3 concentrations (solution: A [1:100], B [1:10] and C [1:1]). Since only 52% of RHS to rituximab are positive in skin tests and given the degree of reaction (serious), desensitization is decided, based on reactions presented by patient and clinical context. Achieving a cumulative dose of 897.87 mg in a period of 5 hours, without reactions during or after the procedure, concluding successfully.
Conclusion: By carrying out desensitization protocols, the administration of a drug is allowed, offering a safe therapeutic option, when this is the treatment of choice in previously sensitized patients, offering an alternative when the benefits outweigh the risks of its administration.
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http://dx.doi.org/10.29262/ram.v70i3.1288 | DOI Listing |
Viruses
November 2024
Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz-BA), Salvador 40296-710, Bahia, Brazil.
Human T-cell leukemia virus type 1 (HTLV-1) is associated with an increased risk of tuberculosis (TB). This study aimed to evaluate the performance of the QuantiFERON-TB Gold (QFT) test for the diagnosis of (MTB) infection in HTLV-1-infected individuals. HTLV-1-infected participants were divided into four groups: HTLV-1-infected individuals with a history of tuberculosis (HTLV/TB), individuals with positive HTLV and tuberculin skin tests (HTLV/TST+) or negative TST (HTLV/TST-), and HTLV-1-negative individuals with positive TST results (HN/TST+).
View Article and Find Full Text PDFPharmaceutics
November 2024
Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), Brasília 70910-900, DF, Brazil.
Although androgenic alopecia is the most prevalent among non-cicatricial alopecia, it still lacks an effective and safe treatment. Dutasteride (DUT) shows promising results in hair regrowth; however, oral DUT intake causes serious sexual adverse events. Hence, we produced liposomes with different bilayer structures and evaluated the capability of such systems in increasing DUT accumulation in the hair follicles.
View Article and Find Full Text PDFPharmaceutics
November 2024
School of Life Science and Technology, Wuhan Polytechnic University, Wuhan 430023, China.
: Sodium aescinate (SA) is commonly used topically due to its anti-inflammatory, anti-edematous, and anti-swelling properties. However, the clinical application of SA is limited by strong irritation, and cannot be used on the damaged skin and mucous membrane. This study aimed to investigate whether arginine hydrochloride (Arg·HCl) could reduce the rectal mucosal irritation of SA through the formation of a gel.
View Article and Find Full Text PDFMicroorganisms
December 2024
Department of Microbiology, Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, Akad. G. Bonchev Street, bl. 26, 1113 Sofia, Bulgaria.
Biofilms are a well-known multifactorial virulence factor with a pivotal role in chronic bacterial infections. Their pathogenicity is determined by the combination of strain-specific mechanisms of virulence and the biofilm extracellular matrix (ECM) protecting the bacteria from the host immune defense and the action of antibacterials. The successful antibiofilm agents should combine antibacterial activity and good biocompatibility with the capacity to penetrate through the ECM.
View Article and Find Full Text PDFPathogens
November 2024
Yunnan Province Key Laboratory of Children's Major Diseases Research, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China.
The aim of this study was to evaluate the diagnostic accuracy of the IGRA, TST, and TBST by combining diagnostic test accuracy (DTA) analysis and network meta-analysis (NMA) to increase the reliability and accuracy of diagnostic methods and promote the eradication of TB. An electronic search of the PubMed, Embase, and Cochrane databases was conducted, from the date of establishment to September 30, 2024. Data were synthesized with frequentist random-effects network meta-analyses, a single-group rate meta-analysis algorithm, and a bivariate mixed-effects logistic regression model.
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