Ali Selda, Nedelcu Denisa-Mihaela, Serescu Radu, Bumbăcea Roxana Silvia
Allergology Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Allergology Department, "Dr. Carol Davila" Nephrology Clinical Hospital, 010731 Bucharest, Romania.
J Clin Med. 2024 Dec 21;13(24):7824. doi: 10.3390/jcm13247824.
is a topoisomerase I inhibitor used for the treatment of various cancers, such as gastrointestinal, pancreatic, pulmonary, ovarian, and cervical cancers. Among chemotherapy agents, it represents a rare trigger of drug hypersensitivity reactions, with few cases being reported until today. We present the case of a patient with metastatic esophageal cancer and a history of -induced grade IV (WAO classification) anaphylaxis. An IgE-mediated reaction was confirmed in our case, as evidenced by a positive intradermal skin test result, and we carried out a successful desensitization protocol, given indispensability in the treatment regimen. Our case underscores the fact that in such situations where the culprit drug is also the only therapeutic option available for such a patient, implementing a desensitization protocol may represent the only viable approach to ensure safe and successful dosing. A comprehensive review of the literature was also conducted to assess previously reported -induced hypersensitivity reactions, the utility of skin tests in identifying sensitisation to , and the existing desensitization protocols. We found a total of seventeen cases of hypersensitivity reactions to in the literature, out of which four provided the skin test results obtained and six performed desensitization protocols for . Our literature review highlights that skin testing and desensitization protocols can provide suitable solutions for managing hypersensitivity reactions to .
是一种拓扑异构酶I抑制剂，用于治疗各种癌症，如胃肠道癌、胰腺癌、肺癌、卵巢癌和宫颈癌。在化疗药物中，它是药物过敏反应的罕见诱因，迄今为止报道的病例很少。我们报告了一例转移性食管癌患者的病例，该患者有因[药物名称]诱发的IV级（世界变态反应组织分类）过敏反应病史。在我们的病例中证实了IgE介导的反应，皮内皮肤试验结果呈阳性证明了这一点，并且由于[药物名称]在治疗方案中不可或缺，我们实施了成功的脱敏方案。我们的病例强调了这样一个事实，即在这种情况下，罪魁祸首药物也是该患者唯一可用的治疗选择，实施脱敏方案可能是确保安全和成功给药的唯一可行方法。我们还对文献进行了全面综述，以评估先前报道的因[药物名称]诱发的过敏反应、皮肤试验在识别对[药物名称]致敏方面的效用以及现有的脱敏方案。我们在文献中总共发现了17例对[药物名称]过敏反应的病例，其中4例提供了获得的皮肤试验结果，6例对[药物名称]实施了脱敏方案。我们的文献综述强调，皮肤试验和脱敏方案可以为管理对[药物名称]的过敏反应提供合适的解决方案。
