Eculizumab
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Possible anaphylaxis (first report) in an elderly patient: case report A 72-year-old woman experienced possible anaphylaxis within minutes of receiving eculizumab for paroxysmal nocturnal haemoglobinuria (PNH). The woman was diagnosed with PNH in 2002 and required frequent blood transfusions. In 2007 she received her first infusion of eculizumab [dosage not stated]. Within minutes she developed hypotension and abdominal pain, leading to termination of the infusion. A second infusion was attempted but she developed perioral pruritus within minutes and the infusion was stopped. Iron overload in 2009 led to reconsideration of eculizumab therapy; a skin test was negative for eculizumab. A desensitisation/progressive dose challenge protocol was developed. The woman was admitted to an ICU and, following premedication with diphenhydramine, hydrocortisone and ranitidine, underwent the challenge protocol without adverse effects. Subsequently, eculizumab infusions were well tolerated following a similar pretreatment protocol. Pesek R, et al. POSSIBLE ANAPHYLAXIS WITH ECULIZUMAB AND SUCCESSFUL TREATMENT USING A DESENSITIZATION/PROGRESSIVE DOSE CHALLENGE PROTOCOL. 2009 Annual Meeting of the American College of Allergy, Asthma and Immunology : abstr. P220, 5 Nov 2009. Available 803004712 from: URL: http://www.acaai.org - USA
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Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of anaphylaxis associated with eculizumab. The WHO ADR database contained one report of anaphylactic reaction associated with eculizumab.
0114-9954/10/1285-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 23 Jan 2010 No. 1285
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