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Angioedema and hypersensitivity: case report A 36-year-old woman developed hypersensitivity reaction during treatment with rituximab, and she developed angioedema during treatment with eculizumab for catastrophic antiphospholipid syndrome [CAPS; not all times to reactions onset stated; routes and dosages not stated]. The woman, who had history of systemic lupus erythematosus and antiphospholipid antibody syndrome, presented to hospital with fetal demise at 17 weeks of gestation. On admission, she had acute liver injury, hepatosplenic infarction and pancytopenia. A diagnosis of CAPS was confirmed on placental biopsy. Despite unspecified pulse steroids, plasmapheresis, IV immune globulin and rituximab, thrombocytopenia continued to worsen. Further, she developed rituximab-associated hypersensitivity reaction. Subsequently, she started receiving eculizumab. Six hours following the first infusion, she developed isolated tongue swelling, suggestive of angioedema. The woman underwent medical management for the angioedema. Following resolution of the angioedema, she underwent a 12-step rapid desensitisation protocol. A continued single-day outpatient desensitisation followed, with close monitoring [not all outcomes stated]. Author comment: "[H]er course was complicated by suspected hypersensitivity reaction (HSR) to rituximab." "Eculizumab was initiated and six hours after the first infusion, she developed isolated tongue swelling" Waqar O, et al. ECULIZUMAB-INDUCED ANGIOEDEMA AND SUCCESSFUL RAPID DESENSITIZATION IN A PATIENT WITH CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME (CAPS). Annals of Allergy, Asthma and Immunology 123 (Suppl.): S75, No. 5, Nov 2019. Available from: URL: https:// 803431949 www.annallergy.org/issues [abstract] - USA

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Reactions 9 Nov 2019 No. 1778