Fever as the only manifestation of hypersensitivity reactions associated with oxaliplatin in a patient with colorectal cancer Oxaliplatin-induced hypersensitivity reaction
Autor: | M. Wasif Saif, Jennifer Madison, Leslie Ledbetter, Shailja Roy, Kostas N. Syrigos |
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Rok vydání: | 2007 |
Předmět: |
Fever
Organoplatinum Compounds Erythema Nausea Case Report Antineoplastic Agents Adenocarcinoma Drug Hypersensitivity medicine Humans business.industry Gastroenterology General Medicine Middle Aged medicine.disease Rash Oxaliplatin Hypersensitivity reaction Peripheral neuropathy Anesthesia Vomiting Female Chills Hypotension medicine.symptom Colorectal Neoplasms business medicine.drug |
Zdroj: | World Journal of Gastroenterology. 13:5277 |
ISSN: | 1007-9327 |
DOI: | 10.3748/wjg.v13.i39.5277 |
Popis: | Hypersensitivity reactions (HSR) to oxaliplatin in patients with colorectal cancer include facial flushing, erythema, pruritus, fever, tachycardia, dyspnea, tongue swelling, rash/hives, headache, chills, weakness, vomiting, burning sensations, dizziness, and edema. We report a patient with fever as the sole manifestation of initial HSR, review the literature and discuss the management of HSR. A 57-year-old female with T3N2M0 rectal adenocarcinoma received modified FOLFOX-6. She tolerated the first 8 cycles without any toxicities except grade 1 peripheral neuropathy and nausea. During 9th and 10th infusions, she developed fever to a maximum of 38.3 centigrade with stable hemodynamic status despite medications. During 11th infusion, she developed grade 3 HSR consisting of symptomatic bronchospasm, hypotension, nausea, vomiting, cough, and fever. On examination, she was pale, cyanotic, with a temperature of 38.8 centigrade, BP dropped to 95/43 mm Hg, pulse of 116/min and O(2) saturation of 88%-91%. She was hospitalized for management and recovered in 24 h. Fever alone is not a usual symptom of oxaliplatin HSR. It may be indicative that the patient may develop serious reactions subsequently, as did our patient who developed hypotension with the third challenge. Treatment and prevention consists of slowing the infusion rate, use of steroids and antagonists of Type 1 and 2 histamine receptor antagonists, whereas desensitization could help to provide the small number of patients who experience severe HSR with the ability to further receive an effective therapy for their colorectal cancer. |
Databáze: | OpenAIRE |
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