Management of Hypersensitivity Reactions to Nondextran Iron Products: New Insights Into Predisposing Risk Factors

BackgroundHypersensitivity reactions (HSRs) to nondextran iron products (NDIPs) are rare, but can manifest with severe signs and symptoms. Predisposing risk factors not well understood.ObjectiveTo characterize patients HSRs NDIPs, a special focus on possible factors.MethodsWe analyzed clinical characteristics of NDIPs referred our allergy division between 2007 2019 compared tolerant controls, including the type eliciting NDIP, severity HSR, atopy status, history allergies urticaria, laboratory skin test results, outcome reexposure NDIPs.ResultsWe evaluated data 59 21 controls. Sixteen 4 controls received NDIP sucrose 41 15 ferric carboxymaltose. In 2 in culprit was known. Twenty-seven (46%) experienced an anaphylactic reaction grade I, (25%) II reaction, 17 (29%) III according Ring Messmer. On analyzing history, we found that 22 (37%) 3 (14%) reported previous other medications. Interestingly, more than half (n = 35 [59%]) only 7 (33%) episode any urticaria their history. Most [79%]) tolerated using low-reactogenic administration protocol.ConclusionsA drug hypersensitivity represent potential for NDIPs. basis findings, propose algorithm practical management receiving aiming prevent HSRs. Hypersensitivity understood. To factors. We protocol. A