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Case Reports
. 2018 Mar 12:14:8.
doi: 10.1186/s13223-018-0233-1. eCollection 2018.

A novel outpatient desensitization protocol for recombinant human erythropoietin allergy in a pediatric patient

Jaime S Rosa  1   2 , Van B Vuong  2 , Orly Haskin  2   3 , Anne Y Liu  1   2
Affiliations
Case Reports

A novel outpatient desensitization protocol for recombinant human erythropoietin allergy in a pediatric patient

Jaime S Rosa et al. Allergy Asthma Clin Immunol. .

Abstract

Background: Recombinant human erythropoietin, such as epoetin alfa and darbepoetin alfa, is an important therapy for anemia due to chronic renal failure. Allergy to recombinant human erythropoietin and the need for desensitization are rare.

Case presentation: We report here a novel epoetin alfa outpatient desensitization protocol in a girl who developed delayed cutaneous hypersensitivity to subcutaneous epoetin alfa and intravenous darbepoetin alfa. An initial attempt at traditional epoetin alfa desensitization failed, so we created a slower 17-day outpatient desensitization that succeeded and allowed treatment continuation.

Conclusions: This case highlights the notion that delayed-type hypersensitivity to recombinant human erythropoietin can occur as evident by reproducible reactions after repeated exposures and slow outpatient desensitization can be considered when a trial of more rapid induction of tolerance is unsuccessful.

Keywords: Child; Desensitization; Drug allergy; Epoetin alfa; Hypersensitivity; Pediatric.

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Figures

Fig. 1
Fig. 1
The patient developed an intensely pruritic, maculopapular rash during the second day of the first desensitization protocol
See this image and copyright information in PMC

References

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