A rapid desensitization protocol in a case of drotaverine‑induced serum sickness-like reaction in a pregnant woman: A case report

Abstract

Drotaverine is an antispasmodic drug used to treat gastrointestinal and genitourinary smooth muscle spasms. There are very few hypersensitivity reactions reported. Serum sickness-like disease is an immune-complex-mediated hypersensitivity reaction that presents with some typical features that include rash, fever and articular impairment sometimes associated with liver and renal dysfunctions, beginning 1-2 weeks after exposure to a culprit drug. Diagnosis is a clinical one, made usually on the basis of knowledge obtained by medical history and physical examination. Desensitization usually is recommended for type I reaction, but may be a solution for this type of immunological reaction when other therapeutic alternatives are ineffective or do not exist. We report the case of a 29-year-old pregnant female who developed serum sickness-like reaction after 5 days of daily drotaverine oral administration. The patient required antispasmodic treatment, with this drug, having a pregnancy with an imminent risk of abortion and the other therapeutic alternatives being ineffective. She underwent a rapid 7-step oral drotaverine desensitization protocol without recurrence of serum sickness-like reaction. To our knowledge, this is the first case report of desensitization to drotaverine, previously involved in a serum sickness-like reaction.

Serum sickness-like reaction following an administration of the first dose of inactivated COVID19 vaccine

“…Successful attempts of desensitization in patients who developed SSLR have been documented in only a few cases. 10 Regarding disease prognosis, SSLR is self-limited within 1-2 weeks upon removing the causes. 6 However, nonsteroidal anti-inflammatory agents or corticosteroid treatment may be needed for patients with severe disease.…”

Serum Sickness-Like Reaction Associated with Epstein – Barr Virus: Clinical Case

“…Диф фе ренциальная диагностика проводилась с острым геморрагическим отеком детского возраста, эозинофильным кольцевидным дерматозом, мигрирующей эритемой, кожными проявлениями красной волчанки, маргинальной эритемой, микозом гладкой кожи, центробежной кольцевидной эритемой, уртикарным васкулитом, многоформной экссудативной эритемой, кожными проявлениями васкулита мелких сосудов кожи. ОБСУЖДЕНИЕ SSLR может развиваться у взрослых пациентов, но большинство случаев описаны у детей [8,9]. Распространенность SSLR неизвестна.…”

[Editorial] Highlights of the 3rd conference of the Romanian Association of Immuno‑Dermatology and the 37th conference of the Romanian Society of Immunology held in Bucharest between September 19 and 22, 2019

“…Ali et al (22) in their article entitled ‘A rapid desensitisation protocol in a case of drotaverine induced serum sickness-like reaction in a pregnant woman: A case report’ reported the first case report of desensitisation to drotaverine, previous involved in a serum sickness-like reaction.…”