Two case reports of desensitization in patients with hypersensitivity to iron

Abstract

Background: Iron deficiency anemia is a disease that can significantly compromise a patient's quality of life. Desensitization is a safe and effective treatment option for iron-deficient anemic patients who require intravenous iron despite their hypersensitivity to iron. This report describes a safe desensitization protocol for patients with iron hypersensitivity who require iron treatment for their clinical improvement. Case presentation: Two patients of 20 and 46-year-old diagnosed with secondary iron deficiency anemia hipermenorreas and a clinical history of fail treatment with oral iron, who presented a reaction of the anaphylactic type while they receive iron parenteral sucrose. Therefore, the patients were treated with the desensitization protocol applied for patients with hypersensitivity to iron. Conclusion: Iron deficiency anemia is a disease that can significantly compromise the quality of life of patients. The desensitization protocol for patients with hypersensitivity to iron is a safe and effective treatment option for patients with a history of allergy to intravenous iron. This case report shows the usefulness to use the desensitization protocol for patients with hypersensitivity to iron.

Desensitization in Iron Product Allergy

“…Notably, desensitization was effective for both oral iron and IV preparations. These results are in line with the sparse reports existing in the literature describing desensitization for iron products [2][3][4][5][6].…”

“…In particular, intravenous (IV) iron therapy is widely used when oral iron preparations are not tolerated or ineffective. Indeed, IV iron improves iron storages more rapidly [2].…”

“…In these cases, desensitization may be necessary. However, few desensitization protocols for iron products have been reported [2][3][4][5][6].…”

Canadian expert consensus: management of hypersensitivity reactions to intravenous iron in adults

“…Following full review, 15 articles were excluded, leaving 11 articles included in the final review: one guidance document on managing hypersensitivity reactions to IV iron , one consensus report on iron management in chronic kidney disease , three reviews of hypersensitivity reactions , two articles assessing incidence and comparative risks , and four articles describing case reports of signs, symptoms and managing reactions . Review of the references of these articles, as well as personal records of the panel, identified an additional eight articles: one review of hypersensitivity reactions ; two analyses of the rates of reaction with IV iron based on observational data ; four articles describing case reports of signs, symptoms and managing reactions ; and the European Medicines Agency (EMA)'s assessment report for iron‐containing IV medicinal products, a comprehensive review of available safety data on IV iron, including post‐marketing incident reports .…”

“…While infusion rates and the timing of escalation may differ in various low reactogenic protocols, all such protocols start the infusion at a very low rate such that 0·001–0·01% of the full dose is infused in the first 5–15 min . More recently, desensitization protocols for IV iron administration in individuals with a history of anaphylaxis to IV iron have been published . Both low reactogenic and desensitization protocols often include pretreatment with systemic corticosteroids and antihistamines.…”