TY - JOUR
T1 - Evaluation and management of pediatric patients with anaphylactoid reactions to deferoxamine mesylate [4]
AU - Somech, Raz
AU - Seaban-Adel, Kimberley
AU - Atkinson, Adelle
AU - Kirby-Allen, Melanie
PY - 2007/12
Y1 - 2007/12
N2 - Indications:3 patients with transfusional iron overload. Coexisting diseases: thalassemia major (n=2) and sickle cell disease (n=1).Patients:3 patients, age range 6-14 years.TypeofStudy:Evaluation and management of anaphylactoid reactions to Desferal in three thalassemic children with transfusional iron overload or sickle cell disease is described. 3 case reports.DosageDuration:During desensitization protocol: initially 0.00375 mg in 10 mL of saline solution followed by 0.0375, 0.375, 3.75, and 37.5 mg in 10 mL of saline solution at 15-minute intervals and then 375 and 500 mg in 15 mL of saline solution at 70-minute intervals as iv infusion; 35 mg/kg daily for 5 days weekly if no adverse events occurred; then 50 mg/kg daily for 5 days weekly as maintenance dose. Duration not stated.Results:After exposure to Desferal, patients developed anaphylactic-like symptoms, including breathing difficulties, wheezing, diffuse urticaria, and generalized itching in patient 1; diffuse hives in patient 2; and hypotension and severe abdominal pain in patient 3. Skin test showed positive results in patients 2 and 4, including a pseudopod, which was evident in the 1/100 dilution in patient 3. Patients 1 and 2 underwent an advanced rapid desensitization protocol using a 7-step challenge of increasing Desferal doses. No adverse symptoms occurred the day after desensitization, and later Desferal was used safely and effectively.FreeText:Tests: prick (1/10 dilution) and intradermal (1/100, 1/1,000, 1/10,000, and 1/100,000 dilutions) skin tests for evaluation of anaphylaxis.AdverseEffects:3 patients had anaphylactic-like symptoms including breathing difficulties, wheezing, diffuse urticaria, generalized itching (patient 1), diffuse hives (patient 2), and hypotension and severe abdominal pain (patient 3).AuthorsConclusions:In conclusion, these cases highlight the utility of low concentrations of deferoxamine mesylate for skin testing in the evaluation of patients with suspected anaphylactic reactions to deferoxamine mesylate. When an alternative therapy is not available for patients with intolerance to deferoxamine mesylate, a rapid intravenous desensitization procedure is safe and efficacious.
AB - Indications:3 patients with transfusional iron overload. Coexisting diseases: thalassemia major (n=2) and sickle cell disease (n=1).Patients:3 patients, age range 6-14 years.TypeofStudy:Evaluation and management of anaphylactoid reactions to Desferal in three thalassemic children with transfusional iron overload or sickle cell disease is described. 3 case reports.DosageDuration:During desensitization protocol: initially 0.00375 mg in 10 mL of saline solution followed by 0.0375, 0.375, 3.75, and 37.5 mg in 10 mL of saline solution at 15-minute intervals and then 375 and 500 mg in 15 mL of saline solution at 70-minute intervals as iv infusion; 35 mg/kg daily for 5 days weekly if no adverse events occurred; then 50 mg/kg daily for 5 days weekly as maintenance dose. Duration not stated.Results:After exposure to Desferal, patients developed anaphylactic-like symptoms, including breathing difficulties, wheezing, diffuse urticaria, and generalized itching in patient 1; diffuse hives in patient 2; and hypotension and severe abdominal pain in patient 3. Skin test showed positive results in patients 2 and 4, including a pseudopod, which was evident in the 1/100 dilution in patient 3. Patients 1 and 2 underwent an advanced rapid desensitization protocol using a 7-step challenge of increasing Desferal doses. No adverse symptoms occurred the day after desensitization, and later Desferal was used safely and effectively.FreeText:Tests: prick (1/10 dilution) and intradermal (1/100, 1/1,000, 1/10,000, and 1/100,000 dilutions) skin tests for evaluation of anaphylaxis.AdverseEffects:3 patients had anaphylactic-like symptoms including breathing difficulties, wheezing, diffuse urticaria, generalized itching (patient 1), diffuse hives (patient 2), and hypotension and severe abdominal pain (patient 3).AuthorsConclusions:In conclusion, these cases highlight the utility of low concentrations of deferoxamine mesylate for skin testing in the evaluation of patients with suspected anaphylactic reactions to deferoxamine mesylate. When an alternative therapy is not available for patients with intolerance to deferoxamine mesylate, a rapid intravenous desensitization procedure is safe and efficacious.
UR - http://www.scopus.com/inward/record.url?scp=37349073105&partnerID=8YFLogxK
U2 - 10.1016/S1081-1206(10)60392-4
DO - 10.1016/S1081-1206(10)60392-4
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AN - SCOPUS:37349073105
SN - 1081-1206
VL - 99
SP - 575
EP - 576
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
IS - 6
ER -