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Titolo:
Case reports of evaluation and desensitization for anti-thymocyte globulinhypersensitivity
Autore:
Millar, MM; Grammer, LC;
Indirizzi:
Northwestern Univ, Sch Med, Div Allergy Immunol, Chicago, IL 60611 USA Northwestern Univ Chicago IL USA 60611 rgy Immunol, Chicago, IL 60611 USA NW Mem Hosp, Dept Med, Ernest Bazley Asthma & Allerg Dis Ctr, Chicago, IL 60611 USA NW Mem Hosp Chicago IL USA 60611 & Allerg Dis Ctr, Chicago, IL 60611 USA NW Mem Hosp, Dept Med, Div Allergy Immunol, Chicago, IL 60611 USA NW Mem Hosp Chicago IL USA 60611 v Allergy Immunol, Chicago, IL 60611 USA
Titolo Testata:
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY
fascicolo: 4, volume: 85, anno: 2000,
pagine: 311 - 316
SICI:
1081-1206(200010)85:4<311:CROEAD>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE-MARROW FAILURE; SEVERE APLASTIC-ANEMIA; HUMAN-SERUM SICKNESS; ANTITHYMOCYTE GLOBULIN; MYELODYSPLASTIC SYNDROME; LIVER-TRANSPLANTATION; RANDOMIZED TRIAL; HOST DISEASE; THERAPY; RECIPIENTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Grammer, LC Northwestern Univ, Sch Med, Div Allergy Immunol, MC S207,303 EChicago Ave, Chicago, IL 60611 USA Northwestern Univ MC S207,303 E ChicagoAve Chicago IL USA 60611
Citazione:
M.M. Millar e L.C. Grammer, "Case reports of evaluation and desensitization for anti-thymocyte globulinhypersensitivity", ANN ALLER A, 85(4), 2000, pp. 311-316

Abstract

Background: Biologic products of heterologous sera have been used to treata variety of conditions. One example is anti-thymocyte globulin (ATG), which is approved for use in the management of renal transplantation and for aplastic anemia. As ATG is a product of heterologous sera it has the potential for adverse reactions, including anaphylaxis. Patients can be skin tested prior to ATG administration to aid in determining hypersensitivity statusto ATG. Objective: To provide case reports to illustrate evaluation for ATG hypersensitivity. Also, to discuss desensitization procedures for patients who are found to have ATG hypersensitivity, and yet are to receive the medicationas it is judged to be essential. Case Reports: We report four patients who were to receive ATG. The resultsof skin testing and each patient's response to ATC are reviewed to illustrate problems that can occur in evaluating the hypersensitivity status of these patients. Further, some patients also underwent ATG desensitization, but none completed the entire protocol successfully. Their outcomes are reviewed to illustrate problems that can occur with the desensitization procedure. Conclusion: Anti-thymocyte globulin is a product of heterologous sera and has the potential to produce anaphylaxis. It is recommended that patients be skin tested prior to administration to aid in determining hypersensitivity status. Those patients who demonstrate hypersensitivity to ATG should notreceive ATG unless it is deemed essential and benefits are judged to outweigh risks. In these circumstances, patients are candidates for ATG desensitization. Complications with desensitization occurred in the cases attempted, and highlights that desensitization to ATG, a xenogeneic protein, carriesrisk and can be difficult. Physicians involved in such cases should be familiar with interpretation of skin tests and problems that can occur with desensitization.

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Documento generato il 02/06/20 alle ore 01:41:00