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Allergic reaction due to the use of infliximab

Year 2022, Volume: 14 Issue: 3, 74 - 76, 31.12.2022
https://doi.org/10.35514/mtd.2022.76

Abstract

In our case report, we aimed to describe a patient who was diagnosed with ankylosing spondylitis and developed anaphylactoid reaction after receiving infliximab treatment for the second time.
Case Report
A 21-year-old female patient presented to the emergency department with an allergic reaction after intravenous infliximab administration. It was learned that he received the treatment for the second time. It was observed that the general condition of the patient was moderate-poor, GCS:15, swelling of the tongue and lips and difficulty in breathing. We were informed that he had ankylosing spondylitis and familial Mediterranean fever in his history and that he was using prednol. In laboratory examinations, WBC was 31.26 KµL. The patient was monitored in the emergency department. Adrenaline, prednol and avil treatment was given. About 2 hours later, the patient's clinical and vital signs improved. After 12 hours of emergency follow-up, he was discharged with recommendations.
Conclusion
Infiximab, which is preferred in autoimmune diseases, should be applied carefully in terms of allergic reactions and close follow-up should be planned, even if no side effects are observed in the first application.

References

  • Papagoras C, Voulgari PV, Drosos AA. Atherosclerosis and cardiovascular disease in the spondyloarthritides, particularly ankylosing spondylitis and psoriatic arthritis. Clin Exp Rheumatol 2013;31:612-20.
  • Özcan ÖU, Özcan DS, Polat CS, Özyüncü N, Erol Ç. Ventricular Arrhythmia With Cessation of Infliximab in a Patient With Ankylosing Spondylitis. Ankara Üniversitesi Tıp Fakültesi Mecmuası 2015;68(2)1-4. Doi: 10.1501/Tıpfak_000000893.
  • Maxwell LJ, Zochling J, Boonen A, Singh JA, Veras MM, Tanjong Ghogomu E et al. TNF-alpha inhibitors for ankylosing spondylitis. Cochrane Database Syst Rev 2015;4:CD005468. Doi: 10.1002/14651858.CD005468.pub2.
  • Sieper J, Lenaerts J, Wollenhaupt J, Rudwaleit M, Mazurov VI, Myasoutova L et al. All INFAST Investigators. Efficacy and safety of infliximab plus naproxen versus naproxen alone in patients with early, active axial spondyloarthritis: results from the double-blind, placebo-controlled INFAST study, Part 1. Ann Rheum Dis 2014; 73(1): 101-7. Doi: 10.1136/annrheumdis-2012-203201.
  • Özer HTE. Treatment decision in a patient with ankylosing spondylitis in remission. Aegean Medical Journal 2021; 49-52.
  • van der Heijde D, Dijkmans B, Geusens P, Sieper J, DeWoody K, Williamson P et al. Ankylosing Spondylitis Study for the Evaluation of Recombinant Infliximab Therapy Study Group. Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebo-controlled trial (ASSERT) Arthritis Rheum 2005;52(2):582-91. Doi: 10.1002/art.20852.
  • Moreno M, Gratacós J, Torrente-Segarra V, Sanmarti R, Morla R, Pontes C et al. REMINEA study Group. Withdrawal of infliximab therapy in ankylosing spondylitis in persistent clinical remission, results from the REMINEA study. Arthritis Res Ther 2019 Apr 5; 21 (1):88.
  • Şen AP, Onsun N, Küçük ÖS, Cinkaya A. Comparison of Efficiency and Adverse Effects of Etanercept, Infliximab and Adalimumab in Patients with Psoriasis Vulgaris. Turkderm-Turk Arch Dermatol Venereol. 2012; 46(1): 11-14. Doi: 10.4274/turkderm.34976.
  • Özgüneş N, Elbir TZ, Yazıcı S. Pulmonary Tuberculosis Following the Use of Infliximab: A Case Report. Klimik Dergisi 2010;23(2):70-2.
  • Matucci A, Pratesi S, Petroni G, Nencini F, Virgili G, Milla M et al. Allergologicalin vitroandin vivoevaluation of patients withhypersensitivity reactions to infliximab. Clinical &Experimental Allergy, 2013;(43):659-64. Doi: 10.1111/cea.12098.
  • Cheifetz A, Smedley M, Martin S, Reiter M, Leone G, Mayer L et al. The Incidence and Management of Infusion Reactions To Infliximab: A Large Center Experience, American Journal of Gastroenterology 2003;98(6):1315-24. Doi: 10.1111/j.1572-0241.2003.07457.x.
  • Lichtenstein L, Ron Y, Kivity S, Ben-Horin S, Israeli E, Fraser GM et al. Infliximab-Related Infusion Reactions: Systematic Review, Journal of Crohn's and Colitis 2015;9(9):806-15. Doi:10.1093/ecco-jcc/jjv096.

Infliksimab kullanımına bağlı gelişen alerjik reaksiyon

Year 2022, Volume: 14 Issue: 3, 74 - 76, 31.12.2022
https://doi.org/10.35514/mtd.2022.76

Abstract

Amaç
Olgu sunumumuzda Ankilozan spondilit tanısı olan ve infliximab tedavisini 2. kez aldıktan sonra anafilaktoid reaksiyon gelişen hastayı anlatmayı amaçladık.
Olgu
21 yaşında kadın hasta intravenöz İnfliksimab alımı sonrası alerjik reaksiyon ile acil servise başvurdu. Tedaviyi ikinci kez aldığı öğrenildi. Genel durum orta-kötü, GKS:15 olan hastanın dilde ve dudakta şişmesi olduğu ve nefes almakta zorlandığı gözlendi. Özgeçmişinde ankilozan spondilit ve ailevi akdeniz ateşi olduğu ve prednol kullandığı tarafımıza bildirildi. Labaratuvar tetkiklerinde WBC:31.26 KµL idi. Hasta acil serviste monitorize edildi. Adrenalin, prednol ve avil tedavisi verildi. Yaklaşık 2 saat sonra hastanın kliniği ve vital bulguları düzeldi. 12 saat acil servis takibinin ardından önerilerle taburcu edildi.
Sonuç
Otoimmun hastalıklarda tercih edilen infiksimab, ilk uygulamada yan etki görülmese bile alerjik reaksiyonlar açısından dikkatli uygulanmalı ve yakın takibi planlanmalıdır.

References

  • Papagoras C, Voulgari PV, Drosos AA. Atherosclerosis and cardiovascular disease in the spondyloarthritides, particularly ankylosing spondylitis and psoriatic arthritis. Clin Exp Rheumatol 2013;31:612-20.
  • Özcan ÖU, Özcan DS, Polat CS, Özyüncü N, Erol Ç. Ventricular Arrhythmia With Cessation of Infliximab in a Patient With Ankylosing Spondylitis. Ankara Üniversitesi Tıp Fakültesi Mecmuası 2015;68(2)1-4. Doi: 10.1501/Tıpfak_000000893.
  • Maxwell LJ, Zochling J, Boonen A, Singh JA, Veras MM, Tanjong Ghogomu E et al. TNF-alpha inhibitors for ankylosing spondylitis. Cochrane Database Syst Rev 2015;4:CD005468. Doi: 10.1002/14651858.CD005468.pub2.
  • Sieper J, Lenaerts J, Wollenhaupt J, Rudwaleit M, Mazurov VI, Myasoutova L et al. All INFAST Investigators. Efficacy and safety of infliximab plus naproxen versus naproxen alone in patients with early, active axial spondyloarthritis: results from the double-blind, placebo-controlled INFAST study, Part 1. Ann Rheum Dis 2014; 73(1): 101-7. Doi: 10.1136/annrheumdis-2012-203201.
  • Özer HTE. Treatment decision in a patient with ankylosing spondylitis in remission. Aegean Medical Journal 2021; 49-52.
  • van der Heijde D, Dijkmans B, Geusens P, Sieper J, DeWoody K, Williamson P et al. Ankylosing Spondylitis Study for the Evaluation of Recombinant Infliximab Therapy Study Group. Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebo-controlled trial (ASSERT) Arthritis Rheum 2005;52(2):582-91. Doi: 10.1002/art.20852.
  • Moreno M, Gratacós J, Torrente-Segarra V, Sanmarti R, Morla R, Pontes C et al. REMINEA study Group. Withdrawal of infliximab therapy in ankylosing spondylitis in persistent clinical remission, results from the REMINEA study. Arthritis Res Ther 2019 Apr 5; 21 (1):88.
  • Şen AP, Onsun N, Küçük ÖS, Cinkaya A. Comparison of Efficiency and Adverse Effects of Etanercept, Infliximab and Adalimumab in Patients with Psoriasis Vulgaris. Turkderm-Turk Arch Dermatol Venereol. 2012; 46(1): 11-14. Doi: 10.4274/turkderm.34976.
  • Özgüneş N, Elbir TZ, Yazıcı S. Pulmonary Tuberculosis Following the Use of Infliximab: A Case Report. Klimik Dergisi 2010;23(2):70-2.
  • Matucci A, Pratesi S, Petroni G, Nencini F, Virgili G, Milla M et al. Allergologicalin vitroandin vivoevaluation of patients withhypersensitivity reactions to infliximab. Clinical &Experimental Allergy, 2013;(43):659-64. Doi: 10.1111/cea.12098.
  • Cheifetz A, Smedley M, Martin S, Reiter M, Leone G, Mayer L et al. The Incidence and Management of Infusion Reactions To Infliximab: A Large Center Experience, American Journal of Gastroenterology 2003;98(6):1315-24. Doi: 10.1111/j.1572-0241.2003.07457.x.
  • Lichtenstein L, Ron Y, Kivity S, Ben-Horin S, Israeli E, Fraser GM et al. Infliximab-Related Infusion Reactions: Systematic Review, Journal of Crohn's and Colitis 2015;9(9):806-15. Doi:10.1093/ecco-jcc/jjv096.
There are 12 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Report
Authors

Hatice Şeyma Akça 0000-0003-2823-9577

Dilek Atik 0000-0002-3270-8711

Fulya Köse 0000-0003-4101-1630

Hanife Merve Akça 0000-0001-8280-7470

Publication Date December 31, 2022
Submission Date June 7, 2022
Published in Issue Year 2022 Volume: 14 Issue: 3

Cite

Vancouver Akça HŞ, Atik D, Köse F, Akça HM. Allergic reaction due to the use of infliximab. Maltepe tıp derg. 2022;14(3):74-6.