Clinical Case of Drug Allergy to Enzyme Replacement Therapy in a Patient with Mucopolysaccharidosis Type II
Background. Enzyme replacement therapy (ERT) with iduronate-2-sulfatase recombinant forms (idursulfase and idursulfase beta) is effective for the management of mucopolysaccharidosis type II (MPS II). Patients with Hunter syndrome require lifelong ERT that can negate endogenous enzyme deficiency. How...
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Union of pediatricians of Russia
2022-07-01
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| Serie: | Педиатрическая фармакология |
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| Accesso online: | https://www.pedpharma.ru/jour/article/view/2178 |
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| author | Julia G. Levina Nato D. Vashakmadze Leyla S. Namazova-Baranova Elena A. Vishneva Mariya S. Karaseva Natalia V. Zhurkova Kamilla E. Efendieva Anna A. Alekseeva Vera G. Kalugina Artur V. Zaz’yan |
| author_facet | Julia G. Levina Nato D. Vashakmadze Leyla S. Namazova-Baranova Elena A. Vishneva Mariya S. Karaseva Natalia V. Zhurkova Kamilla E. Efendieva Anna A. Alekseeva Vera G. Kalugina Artur V. Zaz’yan |
| author_sort | Julia G. Levina |
| collection | DOAJ |
| description | Background. Enzyme replacement therapy (ERT) with iduronate-2-sulfatase recombinant forms (idursulfase and idursulfase beta) is effective for the management of mucopolysaccharidosis type II (MPS II). Patients with Hunter syndrome require lifelong ERT that can negate endogenous enzyme deficiency. However, hypersensitivity reactions may occur during ERT, and they significantly complicate the implementation of vital therapy.Clinical case description. This article describes clinical case of a child with hypersensitivity reaction to ERT. The patient with confirmed diagnosis of MPS II was administrated with idursulfase. Then, the drug was replaced with idursulfase beta due to the allergic reaction. Thus, even after the drug change, side effects maintained without sustained improvement with underlying glucocorticosteroids (GCS), antihistamines and with decreased infusion rate. Concerning the vital need to continue ERT, this patient with drug allergy to this pharmacotherapeutic group was further administered with combined therapy of cyclosporine and omalizumab. Personalised protocol for the administration of idursulfase beta with desensitization was developed. Such experience was firstly described In Russian patient.Conclusion. The presented personalised combination therapy made it possible to prevent hypersensitivity reactions during ERT in the patient with MPS II. |
| format | Article |
| id | doaj-art-666e065089ca44c8a429bcce968c7918 |
| institution | Matheson Library |
| issn | 1727-5776 2500-3089 |
| language | Russian |
| publishDate | 2022-07-01 |
| publisher | Union of pediatricians of Russia |
| record_format | Article |
| series | Педиатрическая фармакология |
| spelling | doaj-art-666e065089ca44c8a429bcce968c79182025-08-03T19:21:30ZrusUnion of pediatricians of RussiaПедиатрическая фармакология1727-57762500-30892022-07-0119325025710.15690/pf.v19i3.24381912Clinical Case of Drug Allergy to Enzyme Replacement Therapy in a Patient with Mucopolysaccharidosis Type IIJulia G. Levina0Nato D. Vashakmadze1Leyla S. Namazova-Baranova2Elena A. Vishneva3Mariya S. Karaseva4Natalia V. Zhurkova5Kamilla E. Efendieva6Anna A. Alekseeva7Vera G. Kalugina8Artur V. Zaz’yan9Pediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical UniversityPediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical UniversityPediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University; Belgorod National Research UniversityPediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical UniversityPediatrics and Child Health Research Institute in Petrovsky National Research Centre of SurgeryPediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery; Medical Genetic Research Center named after N.P. BochkovPediatrics and Child Health Research Institute in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical UniversityPediatrics and Child Health Research Institute in Petrovsky National Research Centre of SurgeryPediatrics and Child Health Research Institute in Petrovsky National Research Centre of SurgeryChildren’s City Hospital № 1Background. Enzyme replacement therapy (ERT) with iduronate-2-sulfatase recombinant forms (idursulfase and idursulfase beta) is effective for the management of mucopolysaccharidosis type II (MPS II). Patients with Hunter syndrome require lifelong ERT that can negate endogenous enzyme deficiency. However, hypersensitivity reactions may occur during ERT, and they significantly complicate the implementation of vital therapy.Clinical case description. This article describes clinical case of a child with hypersensitivity reaction to ERT. The patient with confirmed diagnosis of MPS II was administrated with idursulfase. Then, the drug was replaced with idursulfase beta due to the allergic reaction. Thus, even after the drug change, side effects maintained without sustained improvement with underlying glucocorticosteroids (GCS), antihistamines and with decreased infusion rate. Concerning the vital need to continue ERT, this patient with drug allergy to this pharmacotherapeutic group was further administered with combined therapy of cyclosporine and omalizumab. Personalised protocol for the administration of idursulfase beta with desensitization was developed. Such experience was firstly described In Russian patient.Conclusion. The presented personalised combination therapy made it possible to prevent hypersensitivity reactions during ERT in the patient with MPS II.https://www.pedpharma.ru/jour/article/view/2178mucopolysaccharidosis type iihunter syndromeenzyme replacement therapyidursulfaseidursulfase betadrug allergyurticariachildrenclinical case |
| spellingShingle | Julia G. Levina Nato D. Vashakmadze Leyla S. Namazova-Baranova Elena A. Vishneva Mariya S. Karaseva Natalia V. Zhurkova Kamilla E. Efendieva Anna A. Alekseeva Vera G. Kalugina Artur V. Zaz’yan Clinical Case of Drug Allergy to Enzyme Replacement Therapy in a Patient with Mucopolysaccharidosis Type II Педиатрическая фармакология mucopolysaccharidosis type ii hunter syndrome enzyme replacement therapy idursulfase idursulfase beta drug allergy urticaria children clinical case |
| title | Clinical Case of Drug Allergy to Enzyme Replacement Therapy in a Patient with Mucopolysaccharidosis Type II |
| title_full | Clinical Case of Drug Allergy to Enzyme Replacement Therapy in a Patient with Mucopolysaccharidosis Type II |
| title_fullStr | Clinical Case of Drug Allergy to Enzyme Replacement Therapy in a Patient with Mucopolysaccharidosis Type II |
| title_full_unstemmed | Clinical Case of Drug Allergy to Enzyme Replacement Therapy in a Patient with Mucopolysaccharidosis Type II |
| title_short | Clinical Case of Drug Allergy to Enzyme Replacement Therapy in a Patient with Mucopolysaccharidosis Type II |
| title_sort | clinical case of drug allergy to enzyme replacement therapy in a patient with mucopolysaccharidosis type ii |
| topic | mucopolysaccharidosis type ii hunter syndrome enzyme replacement therapy idursulfase idursulfase beta drug allergy urticaria children clinical case |
| url | https://www.pedpharma.ru/jour/article/view/2178 |
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