A novel ganciclovir desensitization protocol for a pediatric patient: A case report

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dc.authorscopusid57219209857
dc.authorscopusid57211857542
dc.authorscopusid9036191300
dc.authorscopusid57203864701
dc.authorscopusid6506232857
dc.authorscopusid6602303657
dc.authorscopusid7004473191
dc.contributor.authorSevercan, E. Ulusoy
dc.contributor.authorBal, C. M.
dc.contributor.authorGulen, F.
dc.contributor.authorOzdemir, H. H.
dc.contributor.authorKarapinar, D. Y.
dc.contributor.authorTanac, R.
dc.contributor.authorDemir, E.
dc.date.accessioned2023-01-12T19:56:21Z
dc.date.available2023-01-12T19:56:21Z
dc.date.issued2021
dc.departmentN/A/Departmenten_US
dc.description.abstractA nine year-old girl, having high temperature and stomach ache symptoms, was diagnosed with primary haematophagocytic lymphohistiocytosis. During the treatment, she had neutropenic fever, dyspnea and bronchospasm. Laboratory tests revealed a 7,189,566 cytomegalovirus (CMV)-DNA copies/mL. Ganciclovir therapy was started for CMV pneumonia. At the second infusion of ganciclovir, she had dyspnea, bronchospasm, tachycardia and urticaria. Adrenaline, antihistamines and corticosteroids were administered for anaphylaxis. Treatment was replaced with valganciclovir but there was no clinical or laboratory regression. Because valganciclovir was ineffective and foscarnet could not be provided, we decided to apply desensitization with ganciclovir without performing skin tests because the reaction was anaphylactic. Total dose was 350 mg, for the patient's weight of 35 kg, according to 10 mg/kg daily dose. A (1/1000 dilution), B (1/100 dilution), C (1/10 dilution) and D (no dilution) solutions were prepared. Desensitization began with a 1/10,000(e) of the therapeutic dose, followed by 14 administrations of increasing doses every 30 minutes and lasted 6.5 hours. There was no reaction during desensitization. Patient was subsequently treated with ganciclovir every day without any problem for 21 days. After the treatment, clinical symptoms resolved and CMV-DNA copies were found < 31 IU/mL. In conclusion, we present a rare case of ganciclovir hypersensitivity (allergic or non-allergic?) and a novel protocol of ganciclovir desensitization. (C) 2021 Elsevier Masson SAS. All rights reserved.en_US
dc.identifier.doi10.1016/j.reval.2021.03.195
dc.identifier.endpage599en_US
dc.identifier.issn1877-0320
dc.identifier.issn1877-0320en_US
dc.identifier.issue8en_US
dc.identifier.scopus2-s2.0-85106617522en_US
dc.identifier.scopusqualityQ4en_US
dc.identifier.startpage597en_US
dc.identifier.urihttps://doi.org/10.1016/j.reval.2021.03.195
dc.identifier.urihttps://hdl.handle.net/11454/76840
dc.identifier.volume61en_US
dc.identifier.wosWOS:000722026100007en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherElsevier Masson, Corp Offen_US
dc.relation.ispartofRevue Francaise D Allergologieen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAnaphylaxisen_US
dc.subjectDesensitizationen_US
dc.subjectDrug allergyen_US
dc.subjectGancicloviren_US
dc.subjectChilden_US
dc.subjectGeneral-Considerationsen_US
dc.subjectRapid Desensitizationen_US
dc.subjectDrug Hypersensitivityen_US
dc.subjectAllergyen_US
dc.subjectAntibioticsen_US
dc.titleA novel ganciclovir desensitization protocol for a pediatric patient: A case reporten_US
dc.title.alternativeUn nouveau protocole de désensibilisation au ganciclovir pour un patient pédiatrique : un rapport de casen_US
dc.typeArticleen_US

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