We examined the rise of hypersensitivity reactions (HRs) linked to iron agents, especially as their usage in treating iron deficiency has increased. In this study, we evaluated the clinical features of patients who experienced immediate hypersensitivity reactions (IHRs) to both oral and intravenous (IV) iron preparations.
Our analysis included the medical records of 96 patients with a history of these reactions. Among them, 47 had reactions to oral iron, while 49 reacted to IV iron. We conducted skin-prick tests with various iron salts, but found that these tests weren't very helpful for diagnosing IHRs. In fact, only a small percentage showed a positive reaction.
Interestingly, we noted that patients who were sensitive to IV iron experienced more severe reactions, including cases of anaphylaxis. Despite the challenges in diagnosing these allergies, we successfully conducted desensitization treatments for 15 patients needing iron, specifically using ferric carboxymaltose. This approach proved to be safe and effective, marking an important option for patients requiring iron therapy despite their hypersensitivity.
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We explored the impact of ferric carboxymaltose (FCM) on individuals with hypersensitivity reactions to iron supplements. The study included patients identified through a retrospective analysis, focusing on those who displayed allergic reactions.
In our analysis, we administered different protocols to patients based on their risk profiles. For low-risk patients, a 4-step drug provocation test (DPT) was performed, while those at higher risk underwent an 11-step rapid drug desensitization (RDD) protocol.
The results were promising, showing that the majority of patients could successfully complete FCM treatments without severe allergic reactions. Out of 21 patients undergoing RDD, 95.2% completed the treatment successfully. While some experienced mild reactions, such as urticaria, serious complications were infrequent.
Additionally, 10 low-risk patients who underwent DPT also completed their iron therapy effectively, though a couple of them experienced mild symptoms afterward. Overall, we found that RDD is a reliable method for safely administering FCM and that DPT is beneficial for low-risk individuals.
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