奥马珠单抗过敏样反应的特征
Characterization of an anaphylactoid reaction to omalizumab.
作者信息
Dreyfus David H, Randolph Christopher C
机构信息
Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.
出版信息
Ann Allergy Asthma Immunol. 2006 Apr;96(4):624-7. doi: 10.1016/S1081-1206(10)63560-0.
BACKGROUND
The novel humanized murine monoclonal antibody omalizumab prevents binding of human IgE to its high-affinity receptor. A contraindication to therapy with omalizumab is allergy to the medication or previous immediate-type hypersensitivity or anaphylaxis to omalizumab or similar medications.
OBJECTIVE
To determine whether a 32-year-old woman with asthma, allergic rhinitis, and idiopathic chronic urticaria and angioedema with anaphylactoid reactions to omalizumab could tolerate the medication in a desensitization protocol.
METHODS
Omalizumab was administered after pretreatment with nonsteroidal anti-inflammatory drugs (ibuprofen, 600 mg) while the patient was closely monitored in an intensive care unit.
RESULTS
Omalizumab was well tolerated using this protocol, but a serum sickness-like reaction developed that required discontinuation of the medication after the seventh dose.
CONCLUSIONS
Our experience suggests that some patients with anaphylactoid reactions to omalizumab can tolerate the medication when pretreated with nonsteroidal anti-inflammatory drugs but that a serum sickness-like illness may develop, requiring discontinued use of the medication.
背景
新型人源化鼠单克隆抗体奥马珠单抗可阻止人IgE与其高亲和力受体结合。奥马珠单抗治疗的禁忌证为对该药物过敏或既往对奥马珠单抗或类似药物有速发型超敏反应或过敏反应。
目的
确定一名患有哮喘、过敏性鼻炎、特发性慢性荨麻疹和血管性水肿且对奥马珠单抗有类过敏反应的32岁女性是否能在脱敏方案中耐受该药物。
方法
在使用非甾体抗炎药（布洛芬，600毫克）预处理后给予奥马珠单抗，同时在重症监护病房对患者进行密切监测。
结果
采用该方案时奥马珠单抗耐受性良好，但出现了血清病样反应，在第七剂后需要停药。
结论
我们的经验表明，一些对奥马珠单抗有类过敏反应的患者在使用非甾体抗炎药预处理后可以耐受该药物，但可能会出现血清病样疾病，需要停药。
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