Cardoso Lopes João, Pires Pereira Helena, Mesquita Guedes Catarina, Ribeiro Carmelita, Todo-Bom Ana
Allergy and Clinical Immunology Department, Coimbra Hospital and University Centre, Coimbra, Portugal.
Coimbra Clinical Academic Centre, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Asia Pac Allergy. 2025 Sep;15(3):225-227. doi: 10.5415/apallergy.0000000000000198. Epub 2025 Mar 17.
Hypersensitivity reactions (HSRs) to taxanes, such as paclitaxel, occur in 5% to 10% of patients and can involve immunoglobulin E (IgE) or non-IgE mechanisms. We report a 65-year-old male with lung cancer who developed anaphylactic shock during his second paclitaxel treatment. Positive intradermal tests raised the suspicion of an IgE-mediated reaction and, consequently, the possibility of prior sensitization through environmental exposure to (European yew) pollen. The patient underwent a 17-step desensitization protocol with nab-paclitaxel, a formulation with a lower risk of HSRs, and successfully completed 6 additional treatment cycles without recurrence. This case highlights the role of skin testing, potential environmental factors in taxane allergies, and desensitization protocols as effective strategies to ensure safe and uninterrupted therapy.
对紫杉烷类（如紫杉醇）的超敏反应（HSR）发生在5%至10%的患者中，可能涉及免疫球蛋白E（IgE）或非IgE机制。我们报告一名65岁肺癌男性患者，在第二次紫杉醇治疗期间发生过敏性休克。皮内试验呈阳性增加了对IgE介导反应的怀疑，因此也增加了通过环境暴露于欧洲红豆杉花粉而预先致敏的可能性。该患者接受了17步的白蛋白结合型紫杉醇脱敏方案，该制剂发生HSR的风险较低，并成功完成了另外6个治疗周期且无复发。本病例强调了皮肤试验的作用、紫杉烷过敏中潜在的环境因素以及脱敏方案作为确保安全和不间断治疗的有效策略。
