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首页> 外文期刊>Journal of chemotherapy >Hypersensitivity reaction caused by folinic acid administration: a case report and literature review
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Hypersensitivity reaction caused by folinic acid administration: a case report and literature review

机译：亚叶酸引起的超敏反应：一例报道并文献复习

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摘要

5-Fluorouracil (5-FU) is combined with folinic acid (FA) for enhancing its cytotoxic effects in the colon cancer chemotherapy treatment. Folinic acid has rarely been involved in hypersensitivity reactions. Here, we report a case of FA hypersensitivity in an adult patient initially attributed to oxaliplatin administered concurrently. A 56-year-old male patient diagnosed with colon cancer received twelve cycles of FOLFOX4, one cycle of FOLFIRI plus cetuximab and nine cycles of FOLFOX6 uneventful. At the tenth cycle of FOLFOX6 chemotherapy, after 15 minutes of starting the infusion of oxaliplatin and FA, the patient reported flushing, pruritus and abdominal pain and erythema and oedema developed over the face and thorax. After progression, FOLFIRI plus aflibercept was scheduled and another reaction occurred. At this time, FA was discontinued and the patient received another cycle consisted on irinotecan plus 5-FU without incidences. This episode of hypersensitivity reaction following FA infusion with no oxaliplatin empirically confirmed that the hypersensitivity reaction was secondary to FA. Clinicians should be aware of hypersensitivity reaction with FA, especially when FA is administered concomitantly with oxaliplatin, despite its lower risk to cause hypersensitivity reactions. Furthermore, the similar signs and symptoms associated to the hypersensitivity reactions of each agent, highlight the importance of having a specialised allergist team for to make a prompt diagnose of the causative agent in order to prevent patient harm and proceed properly without unnecessary delays in the scheduled chemotherapy treatments.
机译：5-氟尿嘧啶（5-FU）与亚叶酸（FA）结合使用可增强其在结肠癌化疗中的细胞毒性作用。亚叶酸很少参与超敏反应。在这里，我们报告了最初归因于同时服用奥沙利铂的成年患者中FA超敏反应的情况。一名诊断为结肠癌的56岁男性患者接受了12个周期的FOLFOX4、1个周期的FOLFIRI加西妥昔单抗和9个周期的FOLFOX6。在开始输注奥沙利铂和FA 15分钟后的FOLFOX6化疗的第10个周期，患者报告出现潮红，瘙痒和腹痛，面部和胸部出现红斑和水肿。进展后，安排FOLFIRI加aflibercept发生另一反应。这时，FA停药，患者接受了伊立替康加5-FU的另一周期治疗，无任何意外。 FA输注不加奥沙利铂后出现的超敏反应这一事件凭经验证实超敏反应是继发于FA的。临床医师应意识到与FA的超敏反应，尤其是FA与奥沙利铂同时给药时，尽管其引起超敏反应的风险较低。此外，与每种药物的超敏反应相关的相似症状和体征，突出显示了拥有一支专业的过敏症小组对迅速诊断该病原体的重要性，以防止对患者造成伤害并在计划中避免不必要的延误化学疗法。

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