Abstract

Research Article

Treatment protocol with alternative iron drugs in patients with an allergic reaction during iron replacement therapy

Saltuk Buğra Kaya*

Published: 01 February, 2023 | Volume 7 - Issue 1 | Pages: 001-004

In our study, we aimed to show that alternative iron salts containing different additives are safe to use in patients who have type 1 hypersensitivity reactions to iron drugs and need iron replacement therapy.
Materials and methods: Between January 2022 and June 2022, patients who had previously developed type 1 hypersensitivity reactions with iron preparations and needed iron replacement were included in the study. The study was designed retrospectively. Skin tests were first performed on patients to demonstrate a type 1 hypersensitivity reaction. If skin tests were negative and there was no history of life-threatening anaphylaxis, oral provocation tests were continued. If the absence of variability in symptoms and perimeter values, the drug allergy test was considered negative. 
Results: Twenty-two patients were included in the study. Twenty-one of the patients were female and one was male. Iron deficiency anemia was found in nine patients, and low iron stores in thirteen patients without anemia were found. Type 1 hypersensitivity reaction developed with Iron 3 Carboxymaltose in 7 patients, Iron 2 Sulfate in 5 patients, Iron 2 Glycine in 4 patients, Iron 3 Hydroxy Polymaltose in 4 patients, Iron 2 Fumarate in 1 patient and Iron 3 Hydroxide Sucrose in 1 patient. Allergy tests with all alternative iron drugs containing additional additives were negative.
Conclusion: If patients with allergic reactions cannot be referred to allergy clinics, we think that oral iron salts with different additives can be used after the first dose is given in the hospital under general anaphylaxis precautions. We show that oral iron salts containing different additives can be safely used.

Read Full Article HTML DOI: 10.29328/journal.aaai.1001030 Cite this Article Read Full Article PDF

References

  1. Philip KEJ, Sadaka AS, Polkey MI, Hopkinson NS, Steptoe A, Fancourt D. The prevalence and associated mortality of non-anaemic iron deficiency in older adults: a 14 years observational cohort study. Br J Haematol. 2020 May;189(3):566-572. doi: 10.1111/bjh.16409. Epub 2020 Feb 18. PMID: 32072619; PMCID: PMC7613129.
  2. Tolkien Z, Stecher L, Mander AP, Pereira DI, Powell JJ. Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults: a systematic review and meta-analysis. PLoS One. 2015 Feb 20;10(2):e0117383. doi: 10.1371/journal.pone.0117383. PMID: 25700159; PMCID: PMC4336293.
  3. Auerbach M, Deloughery T. Single-dose intravenous iron for iron deficiency: a new paradigm. Hematology Am Soc Hematol Educ Program. 2016 Dec 2;2016(1):57-66. doi: 10.1182/asheducation-2016.1.57. PMID: 27913463; PMCID: PMC6142502.
  4. Rampton D, Folkersen J, Fishbane S, Hedenus M, Howaldt S, Locatelli F, Patni S, Szebeni J, Weiss G. Hypersensitivity reactions to intravenous iron: guidance for risk minimization and management. Haematologica. 2014 Nov;99(11):1671-6. doi: 10.3324/haematol.2014.111492. PMID: 25420283; PMCID: PMC4222472.
  5. de Barrio M, Fuentes V, Tornero P, Sánchez I, Zubeldia J, Herrero T. Anaphylaxis to oral iron salts. desensitization protocol for tolerance induction. J Investig Allergol Clin Immunol. 2008;18(4):305-8. PMID: 18714540.
  6. Yilmaz O, Erkasar Citak F. A case report with hypersensitivity to ferrous but tolerance of ferric iron salts. J Allergy Clin Immunol Pract. 2016 Mar-Apr;4(2):343-4.e1. doi: 10.1016/j.jaip.2015.11.001. Epub 2015 Nov 25. PMID: 26626063.
  7. Rodríguez-Jiménez B, Domínguez-Ortega J, Nuñez-Acevedo B, Cava-Sumner B, Kindelan-Recarte C, Montojo-Guillén C. Rapid iron desensitization after generalized urticaria and facial angioedema. J Investig Allergol Clin Immunol. 2014;24(1):69-71. PMID: 24765889.
  8. Özdemir Ö, Büyükavcı M. Development of hypersensitivity reactions after using different oral iron preparations. 2018.
  9. Bonadonna P, Brockow K. Drug Hypersensitivity and Clonal Mast Cell Disorders. In Cutaneous Drug Hypersensitivity. Springer, Cham. 2022; 161-165.
  10. Buonomo A, Nucera E, Criscuolo M. Treatment of Indolent and Advanced Systemic Mastocytosis. Mediterr J Hematol Infect Dis. 2022 May 1;14(1):e2022040. doi: 10.4084/MJHID.2022.040. PMID: 35615325; PMCID: PMC9084172.

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