tailieunhanh - Báo cáo y học: "Spondylarthritis presenting with an allergic immediate systemic reaction to adalimumab in a woman: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Spondylarthritis presenting with an allergic immediate systemic reaction to adalimumab in a woman: a case report. | Benucci et al. Journal of Medical Case Reports 2011 5 155 http content 5 1 155 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Spondylarthritis presenting with an allergic immediate systemic reaction to adalimumab in a woman a case report 1 2 -3 3 2 2 Maurizio Benucci Mariangela Manfredi Sergio Testi Maria L lorno Maurizio Valentini Francesca Soldaini and Paolo Campi 3 Abstract Introduction The efficacy of adalimumab a fully human anti-tumor necrosis factor a recombinant antibody has dramatically improved the quality of life of patients with rheumatoid and psoriatic arthritis and Crohn s disease. Because it is fully human one should not expect immune reactions to this molecule. Adverse reactions to adalimumab are limited mainly to injection site reactions and are very common. Immediate systemic reactions are rarely reported. Case presentation We report the case of a 61-year-old Caucasian woman who was treated with adalimumab for spondylarthritis and developed injection site reactions after the sixth dose. After a two-month suspension she recommenced therapy and experienced two systemic reactions. The first occurred after one hour with itching of the palms and soles and angioedema of the tongue and lips. Thirty minutes after the next dose the patient had itching of the palms and soles with diffusion to her whole body angioedema of the lips dizziness and visual disturbances. A skin-prick test and intra-dermal tests with adalimumab gave strong positive results at the immediate reading. However serum-specific immunoglobulin E IgE to adalimumab were not detectable by using Phadia solid phase especially harvested for this case in collaboration with our Immunology and Allergy Laboratory Unit. Her total IgE concentration was kU L. Conclusion We describe what is to the best of our knowledge the first reported case of immediate systemic reaction to adalimumab studied with a skin test giving positive results and a serum-specific IgE .