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Fever as the only manifestation of hypersensitivity reactions associated with oxaliplatin in a patient with colorectal cancer Oxaliplatin-induced hypersensitivity reaction

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World Journal of Gastroenterology 2007年第39期13卷 5277-5281页

作者： M Wasif Saif Shailja Roy Leslie Ledbetter Jennifer Madison Kostas Syrigos Yale University School of Medicine New Haven CT 06520 United States University of Alabama at Birmingham Birmingham AL United States Athens Medical School Sotiria General HospitalAthens Greece

hypersensitivity reactions （HSR） to oxaliplatin in patients with colorectal cancer include facial flushing, erythema, pruritis, fever, tachycardia, dyspnea, tongue swelling, rash/hives, headache, chills, weakness, vomiting, burning sensations, dizziness, and edema. We report a patient with fever as the sole manifestation of initial HSR, review the literature and discuss the management of HSR. A 57-year-old female with T3N2M0 rectal adenocarcinoma received modified FOLFOX-6. She tolerated the first 8 cycles without any toxicities except grade 1 peripheral neuropathy and nausea. During 9th and 10th infusions, she developed fever to a maximum of 38.3℃ with stable hemodynamic status despite medications. During 11th infusion, she developed grade 3 HSR consisting of symptomatic bronchospasm, hypotension, nausea, vomiting, cough, and fever. On examination, she was pale, cyanotic, with a temperature of 38.8℃, BP dropped to 95/43 mm Hg, pulse of 116/min and O2 saturation of 88%-91%. She was hospitalized for management and recovered in 24 h. Fever alone is not a usual symptom of oxaliplatin HSR. It may be indicative that the patient may develop serious reactions subsequently, as did our patient who developed hypotension with the third challenge. Treatment and prevention consists of slowing the infusion rate, use of steroids and antagonists of Type 1 and 2 histamine receptor antagonists, whereas desensitization could help to provide the small number of patients who experience severe HSR with the ability to further receive an effective therapy for their colorectal cancer.

关键词： Oxaliplatin hypersensitivity reaction Fever Colon cancer

Clinical Features of Oxaliplatin-induced hypersensitivity reactions in Chinese Patients: A Retrospective Multicenter Analysis

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Current Medical Science 2021年第4期41卷 827-831页

作者： Min LI Chen JIANG Jing-wen YANG Zao-qin YU Wei LI Li ZHAO Qiu-yan SONG Cheng-liang ZHANG Dong LIU Department of Pharmacy Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Hubei Center for Adverse Drug reaction Monitoring Wuhan 430030China People's Hospital ofYuxi City Yuxi 653100China

Objective The characteristics of oxaliplatin-induced hypersensitivity reactions(HSRs)in Chinese patients were investigated to provide a reference for patients treated with *** The study reviewed the records of patients who developed oxaliplatin-induced HSRs in 17 hospitals from May 2016 to May *** collected and analyzed the basic information,history of oxaliplatin administration and premedication treatments,chemotherapy cycles,HSR symptoms,and the management and outcomes of these *** Oxaliplatin-induced HSRs were recorded in 137 patients who had been treated with oxaliplatin-containing *** different chemotherapy regimens were *** median infusion cycle when oxaliplatin-induced HSRs occurred was 7,and HSRs occurred during or shortly after oxaliplatin *** of the patients experienced grade 1 or grade 2 HSRs with mild symptoms of pruritis(49.64%),flushing(46.72%),chest discomfort(26.28%),and urticaria(25.55%).The majority of the patients completely recovered from HSRs following treatment with antihistamines and *** patients completed chemotherapy with oxaliplatin after the symptoms resolved with proper *** The results indicate that oxaliplatin-induced HSRs remain an important issue in safely and successfully fulfilling oxaliplatin-containing *** studies are needed to analyze the risk factors and establish prophylaxis for such reactions.

关键词： oxaliplatin hypersensitivity reaction retrospective study multicenter

Atezolizumab-induced anaphylactic shock in a patient with hepatocellular carcinoma undergoing immunotherapy:A case report

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World Journal of Clinical Cases 2021年第16期9卷 4110-4115页

作者： Li-Fang Bian Chao Zheng Xiao-Lan Shi Department of Hepatobiliary and Pancreatic Surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Gastrointestinal Surgery The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310006Zhejiang ProvinceChina

BACKGROUND Atezolizumab is a programmed death ligand 1(PD-L1)inhibitor,and its combination with bevacizumab has been proven an effective immunotherapy for unresectable hepatocellular carcinoma(HCC).Treatment with immune checkpoint inhibitors(ICIs)can lead to hypersensitivity reactions;however,anaphylactic shock is *** present a case of life-threatening anaphylactic shock during atezolizumab infusion and performed a relevant literature *** SUMMARY A 75-year-old man was diagnosed with HCC recurrence after *** was administered immunotherapy with atezolizumab plus bevacizumab after an allergy to a programmed death-1(PD-1)*** patient showed a sudden onset of dizziness,numbness,and lack of consciousness with severe hypotension during atezolizumab *** treatment was stopped *** patient’s symptoms resolved after 5 mg dexamethasone was *** of repeated hypersensitivity reactions to ICIs,treatment was changed to oral targeted regorafenib *** Further research is necessary for elucidating the hypersensitivity mechanisms and establishing standardized skin test and desensitization protocols associated with PD-1 and PD-L1 to ensure effective treatment with ICIs.

关键词： Atezolizumab Immune checkpoint inhibitors Anaphylactic shock hypersensitivity reaction Infusion reaction Hepatocellular carcinoma Case report

Drug reaction with Eosinophilia and Systemic Symptoms： Retrospective Analysis of 104 Cases over One Decade

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Chinese Medical Journal 2017年第8期130卷 943-949页

作者： Li Wang Xue-Ling Mei Department of Dermatology Allergy and Clinical Immunology Centre Beijing Friendship Hospital Capital Medical University Beijing 100050 China

Background： Drug reaction with eosinophilia and systemic symptoms （DRESS） is a severe, life-threatening disorder caused by drugs. In the present study, we tried to explore the types of DRESS-inducing drugs, incubation period, features of skin rashes, accompanying visceral damage, and effectiveness of glucocorticoid therapy so as to inform clinical practice. Methods： Patients diagnosed with a drug-induced rash, dermatitis, and DRESS admitted to our hospital from January 2006 to December 2015 were included in the study. The diagnosis followed the criteria and scoring system set by the European Registry of Severe Cutaneous Adverse reactions. Statistical analyses were carried out using SPSS version 17.0 （IBM, Armonk, NY, USA）, and a value ofP 〈 0.05 was considered statistically significant. Results： Among 104 patients, 38 were male and 66 female （aged 18-83 years）. The latent period was 13 （interquartile range [IQR]： 10-17） days. The most common allergy-inducing drugs were antibiotics （n = 37, 35.6%）, followed by antiepileptic drugs and traditional Chinese medicines （TCMs）. Eighty-two cases （78.8%） had rash with area 〉50% body surface area （BSA）. Liver damage occurred in 90% of cases. Patients were divided into oral antihistamine group and glucocorticoid/immunosuppressive agent/intravenous immunoglobulin （IVIG） group. Sex, age, incubation period, duration of hospital stay, and the number of patients with body temperature 〉38.5℃ were not significantly different between the two groups. However, the number of patients meeting the criteria of＂definite＂ and ＂probable＂（X2 =5.852, P = 0.016）, with an eosinophilic granulocyte count of〉1.5 x10^9/L 0,2 7.129, P = 0.008）, and with rash area of〉50% BSA （X2 = 4.750, P = 0.029）, was significantly different. Conclusions： Antibiotics were associated with allergic reactions, but TCMs also had an important role. Allergy resulting from repeat use of the same drug was more severe with a shorter incubation period. The most typical rash was

关键词： Drug reaction Drug reaction with Eosinophilia and Systemic Symptoms Syndrome hypersensitivity reaction