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Case Reports
. 2023 Jun 14;15(6):e40424.
doi: 10.7759/cureus.40424. eCollection 2023 Jun.

Successful Prolonged Desensitization to Epoetin-Alfa Hypersensitivity in an Adult Patient With Advanced Chronic Kidney Disease

Hemali Panchal  1 , Saiyed Ali  2 , Rosemary Hallett  3 , Brian Young  2 , Nasim Wiegley  2
Affiliations
Case Reports

Successful Prolonged Desensitization to Epoetin-Alfa Hypersensitivity in an Adult Patient With Advanced Chronic Kidney Disease

Hemali Panchal et al. Cureus. .

Abstract

The use of erythropoiesis-stimulating agents (ESAs) reduces the need for recurrent blood transfusions in patients with advanced kidney disease. Rarely, allergic reactions to recombinant human erythropoietin can develop, complicating anemia management due to cross-reactivity between these agents. We report the use of an outpatient desensitization protocol, which was successfully completed in an adult patient who developed a maculopapular rash as a form of delayed-type hypersensitivity reaction (DTH) to epoetin-alfa (EPO) use, followed by successful re-introduction of EPO and continued tolerance.

Keywords: anemia of chronic diseases; chronic kidney disease (ckd); desensitization therapy; drug-induced hypersensitivity; synthetic epo.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Histopathologic features of the cutaneous eruption were consistent with a drug reaction
Note the eosinophilic spongiosis, dyskeratotic keratinocytes (arrowhead), and perivascular and interstitial eosinophils (arrow). (Hematoxylin-eosin stain; original magnifications: A, ×100; B, ×400)
See this image and copyright information in PMC

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