AI Article Synopsis
- * A case involving a 71-year-old woman with lymphoma resulted in fatal anaphylactic shock following her first dose of rasburicase, leading to multiple complications including heart compression and significant bleeding.
- * This case highlights that while it’s uncommon, rasburicase can cause deadly anaphylaxis even in patients who have not previously been exposed to the drug.
Article Abstract
Background: Rasburicase, a recombinant urate oxidase enzyme, has potent efficacy in controlling uric acid and is widely used to prevent tumor lysis syndrome in high-risk patients owing to its low toxicity profile. However, it has been associated with a risk of anaphylaxis, especially on re-exposure, owing to its immunogenic potential.
Case Presentation: A 71-year-old Japanese female diagnosed with diffuse large B cell lymphoma with a large tumor burden experienced anaphylactic shock leading to death upon initial administration of rasburicase. The pre-and postmortem examination revealed that the cause of death was a cascade of events starting with anaphylaxis-induced distributive shock leading to obstructive shock due to the collapse of the heart, which was compressed by the post-mediastinal tumor. This was further compounded by massive bleeding from the tumor and tension hemothorax, resulting in circulatory collapse.
Conclusions: Although extremely rare, rasburicase can cause fatal anaphylaxis, even on first exposure.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514887 | PMC |
| http://dx.doi.org/10.1186/s13223-024-00920-9 | DOI Listing |
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