Hypertensive crisis and pulmonary edema following rituximab-induced anaphylaxis

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Stylian Brili
Evangelia Bei
Nikolas G. Kounis
Christina Chrysohoou
Christos-Konstantinos Antoniou
Flora Kontopidou
Laura Bonfanti
Gianfranco Cervellin
Dimitrios Tousoulis Tousoulis
Constantinos Tsioufis

Keywords

Anaphylaxis, hypertensive crisis, Kounis syndrome, pulmonary edema, rituximab

Abstract

Rituximab is a monoclonal antibody against the protein CD20. Various lymphomas as well as non-malignant immune disorders are treated with this antibody. Hypersensitivity reactions associated with the use of rituximab include urticaria, hypotension, chest tightness, vomiting, oxygen desaturation and bronchospasm. A very uncommon case of hypertensive crisis and pulmonary edema following rituximab-induced hypersensitivity reaction in an 80-year-old man receiving rituximab for non-Hodgkin lymphoma is reported. Anaphylaxis manifesting as coronary vasospasm following drug treatment, including rituximab, could be proved a serious condition in patients who need specific treatment. In these patients desensitization protocols seem to be mandatory.

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