Premium
Approach to hypersensitivity reactions from intravenous iron preparations
Author(s) -
Morales Mateluna C. A.,
Scherer Hofmeier K.,
Bircher A. J.
Publication year - 2017
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.13106
Subject(s) - medicine , hypersensitivity reaction , intravenous iron , delayed hypersensitivity , basophil activation , medical record , dermatology , work up , anesthesia , surgery , immunoglobulin e , basophil , iron deficiency , immunology , anemia , antibody , antigen
Hypersensitivity reactions ( HSR s) to intravenous iron preparations ( IVIP s) are well known. With newer preparations, HSR s have become rarer; however, severe reactions may still occur. We retrospectively reviewed records of patients evaluated for HSR s to IVIP s, to determine the safety of controlled re‐administration ( CRA ). Allergological work‐up included a detailed history, skin prick tests ( SPT s) with IVIP , and basophil activation tests ( BAT s) in some patients. CRA with an IVIP was carried out if indicated. Thirty‐one patients with mild to severe reactions were evaluated. SPT s and BAT s were negative in all patients tested. Eighteen CRA s in 15 patients were performed. Twelve patients tolerated the procedure, including three with a previous grade IV HSR . Two developed urticaria and one developed urticaria and dyspnea. The pathophysiology of HSR s to IVIP s remains currently unclear. SPT s and BAT s provided no additional information. However, in appropriate situations, CRA under surveillance can be safely performed in most patients.