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Current Drug Safety
ISSN (Print): 1574-8863
ISSN (Online): 2212-3911
Epub Full Text Article
DOI: 10.2174/1574886309666140509154056      Price:  $95









Desensitization Protocol for Rituximab-Induced Serum Sickness

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Author(s): Merritt L. Fajt and Andrej A. Petrov
Abstract:
Rituximab, a chimeric anti-CD20 monoclonal antibody, is used to treat rheumatologic and hematologic diseases. Serum sickness, a Type III delayed hypersensitivity reaction, has been reported with rituximab treatment. Traditionally, drug desensitization has been used to treat Type I IgE-mediated hypersensitivity reactions. We report the first case of successful drug desensitization to rituximab in a patient with medication-induced serum sickness. In our case, a 37-year-old woman with Sjogren’s syndrome and papillary thyroid carcinoma developed serum sickness 72 hours following rituximab infusion for gastric mucosal associated lymphoma tissue (MALT). Her MALT progressed after stopping rituximab. She underwent a rapid 12-step intravenous rituximab desensitization without recurrence of serum sickness. Following the completion of 4 rituximab desensitizations, she had gastric MALT remission. She received 25 maintenance rituximab doses using this desensitization protocol quarterly without complications. This is the first report documenting rituximab desensitization for the treatment of delayed drug reactions like serum sickness
Keywords:
Desensitization, hypersensitivity, mucosa associated lymphoid tissue, rituximab, serum sickness
Affiliation:
UPMC Montefiore Hospital – NW628, 3459 Fifth Ave Pittsburgh, PA 15213