Abstract

Introduction: When deferasirox is used in iron chelation therapy, maculopapular rash occurs in 10% of patients, but there is no accepted and implemented protocol for the management of these drug reactions in adults. Case report: A 23-year-old woman diagnosed with thalassemia major is presented. She had taken 1,500 mg oral deferasirox for 1 week. Five hours after the last dose, a pruritic maculopapular rash developed on the body, face, and hands. The rash spread to the whole body within 3 days. The absolute necessity for the patient to take the drug was clarified by the hematology department. The patient’s history was evaluated. A delayed-type hypersensitivity reaction due to deferasirox was considered. Management: The slow desensitization protocol described in the literature and applied on a case-by-case basis in pediatric patients was modified to shorten the duration by determining appropriate doses for the current preparation. The desensitization process was started with 1/100,000 of the total dose and the therapeutic dose was reached with a 2- to 2.5-fold increase in dose. No pre-medication was applied. During the procedure, at a low dose of 0.1 mg, local flushing and erythema was observed around the auricle on the face. The reaction did not progress. Conclusion: Slow desensitization protocol for oral deferasirox was successfully applied in an adult patient.

Author Details

Authors

• Buket Basa Akdogan¹
• Ilkay Koca Kalkan¹
• Gozde Koycu Buhari¹
• Ozlem Ozdedeoğlu¹
• Hale Ates¹
• Kurtulus Aksu¹
• Ferda Oner Erkekol²

Departments

• ¹ University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, and
• ² Yıldırım Beyazıt University, Division of Immunology and Allergy, Department of Chest Diseases, Ankara, Türkiye

Address

Buket Basa Akdogan, MD, Incirli st. No:57 Floor:3, 34147 Bakirkoy/Istanbul, Türkiye
Email: [email protected]

Citation