Abstract
An iron hypersensitivity reaction can develop during infusion. Here we present four cases of Rapid Drug Desensitization (RDD) as an option for the treatment of these patients. Urticaria appeared in the second hour of an IV iron sucrose infusion (ISI) performed 8 years previously in case 1 and drug provocation with IV ferric carboxymaltose was performed, but urticaria developed on the arm where the drug was administered immediately after infusing 60 cc. Case 2 developed tongue swelling and shortness of breath within minutes of the IV ISI. Case 3 developed shortness of breath within three minutes after the first dose of IV ISI. Case 4 with iron deficiency anemia reported swelling in the throat, lips and shortness of breath after taking an unknown oral iron therapy. On the 14th day of oral ferrous sulfate therapy, the patient presented with pruritus and skin eruptions occurring 2 hours after drug ingestion. Fifteen RDDs were successfully performed in these cases.
Highlights
Iron deficiency is a common health problem and treatment is generally based on iron supplements as oral iron salts [1]
Urticaria appeared in the second hour of an IV iron sucrose infusion (ISI) performed 8 years previously in case 1 and drug provocation with IV ferric carboxymaltose was performed, but urticaria developed on the arm where the drug was administered immediately after infusing 60 cc
We present four patients with iron hypersensitivity who were successfully desensitized with ferric carboxymaltose (FCM) via Rapid Drug Desensitization (RDD)
Summary
Iron deficiency is a common health problem and treatment is generally based on iron supplements as oral iron salts [1]. The patient developed diarrhea and nausea 4 hours after taking the second dose of ferrous sulfate He developed tongue swelling and shortness of breath within minutes of the IV iron sucrose infusion. A 35-year-old female patient had been diagnosed as having IDA 5 years ago She had had nausea and vomiting 15 minutes after the first dose of an unknown oral iron tablet. On the 14th day of oral ferrous sulfate therapy, the patient presented with extensive pruritus, and erythematous punctate eruptions that had occurred 2 hours after drug ingestion She had suffered urticarial plaques on the whole body and swelling of the throat and lips occurring 7 years ago after taking some non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics. No breakthrough reactions were noted during or after the infusion
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