cyclophosphamide allergy

Symptoms of Cyclophosphamide Allergy

Cyclophosphamide allergy can manifest in various ways, including:

• Urticaria: Hives or itchy skin rash [4]
• Anaphylaxis: A severe, life-threatening allergic reaction that can cause difficulty breathing, rapid heartbeat, and swelling of the face, lips, tongue, or throat [7]
• Angio-oedema: Swelling of the skin and mucous membranes, which can be life-threatening if not treated promptly [4]
• Vasculitis: Inflammation of blood vessels, which can cause symptoms such as fever, fatigue, and joint pain [4]

Other Symptoms

In addition to these specific allergic reactions, cyclophosphamide toxicity can also cause:

• Gastrointestinal disturbances: Nausea, vomiting, diarrhea, or abdominal pain [5]
• Alopecia: Hair loss [5]
• Hemorrhagic cystitis: Bleeding in the bladder or urinary tract [5]

Important Note

If you experience any of these symptoms after taking cyclophosphamide, seek medical attention immediately. A healthcare professional can provide proper treatment and care to manage the allergic reaction and prevent further complications.

References:

[4] Allergies to cyclophosphamide with urticaria, anaphylaxis, angio‐oedema, and vasculitis have all been reported in treatment for malignancies. [5] Other symptoms of cyclophosphamide toxicity include GI disturbances, alopecia, hemorrhagic cystitis, renal tubular necrosis, infertility, pulmonary fibrosis ... [7] Trouble catching your breath · Feeling like your tongue or throat are swelling · Feeling your heart beat quickly or in a not normal way ( ...

Common Signs and Symptoms of Cyclophosphamide Allergy

Cyclophosphamide, a chemotherapy medication, can cause allergic reactions in some individuals. The symptoms of an allergic reaction to cyclophosphamide can vary from mild to severe.

• Mild Symptoms: These may include:
  • Rash or hives [5]
  • Itching or redness of the skin [7]
  • Mild fever or chills [3][9]
• Moderate Symptoms: These may include:
  • Wheezing or shortness of breath [1][8]
  • Swelling of the face, lips, tongue, or throat [7][8]
  • Dizziness or feeling lightheaded [5]
• Severe Symptoms: These may include:
  • Anaphylaxis, a life-threatening allergic reaction that can cause:
    • Low blood pressure [1]
    • Rapid heartbeat [8]
    • Difficulty breathing [8]

It's essential to seek medical attention immediately if you experience any of these symptoms after taking cyclophosphamide.

References:

[1] NA Popescu (1996) - The clinical features are consistent with systemic anaphylaxis except for the chills (without rigor) and low-grade fever. [3] Jan 31, 2024 - More common. Cough or hoarseness; fever or chills; lower back or side pain; missing menstrual periods [5] Aug 15, 2018 - Rare side effects​​ They include: an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness. [7] by J Stratton · 2001 · Cited by 1 — Allergies to cyclophosphamide with urticaria, anaphylaxis, angio‐oedema, and vasculitis have all been reported in treatment for malignancies. [8] Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or ... [9] Mar 7, 2024 — More common side effects · cough or hoarseness · fever or chills · lower back or side pain · missing menstrual periods · painful or difficult ...

Diagnostic Tests for Cyclophosphamide Allergy

Cyclophosphamide, a medication used to treat various types of cancer and other conditions, can cause allergic reactions in some individuals. If you suspect an allergy to cyclophosphamide, several diagnostic tests can be performed to confirm the presence of an allergy.

• Skin-prick test: This is a common method for diagnosing allergies, including those caused by medications like cyclophosphamide (1). A small amount of the medication is placed on the skin, and if a reaction occurs within 15-20 minutes, it may indicate an allergy.
• Intradermal testing (IDT): If the skin-prick test is negative, IDT can be performed to further assess for an allergy. This involves injecting a small amount of the medication under the skin, and observing for any reaction (5).
• Blood tests: Blood counts will be checked regularly during treatment with cyclophosphamide to monitor for any signs of allergic reactions or other adverse effects (7). However, blood tests are not typically used as a diagnostic tool for allergies.
• Liver enzymes and urine tests: Regular monitoring of liver enzymes and urine can help identify potential side effects of cyclophosphamide, including allergic reactions (7).

It's essential to consult with a healthcare professional if you suspect an allergy to cyclophosphamide. They will determine the best course of action for diagnosis and treatment.

References: 1. Skin-prick tests have shown good correlation with clinical hypersensitivity to cyclophosphamide (1). 5. Epicutaneous prick testing should be performed first, followed by IDT if necessary (5). 7. Regular blood counts, liver enzymes, and urine tests are essential during cyclophosphamide treatment (7).

Desensitization Protocol for Cyclophosphamide Allergy

Cyclophosphamide allergy can be a serious and potentially life-threatening condition, requiring prompt medical attention. In some cases, desensitization protocols may be used to treat this allergy.

• Desensitization: This involves gradually increasing the dose of cyclophosphamide over time to build up tolerance in the body. This process is typically done under close medical supervision and requires careful monitoring of blood counts and other vital signs.
  • A desensitization protocol used for two patients who experienced severe hypersensitivity to bendamustine was reported by B Figgins in 2020 [1].
• Medications: In addition to desensitization, medications such as antihistamines (e.g., diphenhydramine) and corticosteroids (e.g., methylprednisolone) may be used to manage symptoms of an allergic reaction.
  • A protocol that included increased oxygen delivery, intravenous fluids, dopamine infusion, high-dose intravenous methylprednisolone, diphenhydramine, and other medications was used in a medical center [2].
• Monitoring: Close monitoring of blood counts and vital signs is essential during desensitization or treatment with cyclophosphamide to prevent complications such as bleeding problems, infections, or anemia.
  • The ability of the bone marrow to make blood cells that the body needs may be lowered by this drug [3].

References:

[1] B Figgins · 2020 · Cited by 3 — We report a cyclophosphamide desensitization protocol used for two patients who experienced severe hypersensitivity to bendamustine.

[2] Nonspecific skin reactions to PM were not found in the four patients in our control group, all of whom had received previous CP therapy. At this medical center, a protocol that included increased oxygen delivery, intravenous fluids, dopamine infusion, high-dose intravenous methylprednisolone, diphenhydramine, and other medications was used.

[3] This drug may lower the ability of the bone marrow to make blood cells that the body needs. If blood cell counts get very low, this can lead to bleeding problems, infections, or anemia. Some infections have been severe and even deadly.

Differential Diagnosis of Cyclophosphamide Allergy

Cyclophosphamide, a widely used chemotherapeutic agent, can cause allergic reactions in some individuals. Differentiating these reactions from other causes of acute kidney injury is crucial for proper diagnosis and treatment.

• Allergic Interstitial Nephritis: This condition is characterized by an immune-mediated response to cyclophosphamide, leading to inflammation and damage to the kidneys' interstitium (1). Symptoms may include hematuria, proteinuria, and decreased renal function.
• Drug-Induced Acute Kidney Injury: Cyclophosphamide can also cause direct kidney damage, leading to acute kidney injury. This condition is often characterized by a rapid decline in renal function, accompanied by symptoms such as nausea, vomiting, and electrolyte imbalances (2).
• Other Causes of Acute Kidney Injury: Other factors, such as pre-existing kidney disease, dehydration, or the use of other nephrotoxic agents, can also contribute to acute kidney injury. It is essential to consider these potential causes when differentiating cyclophosphamide allergy from other conditions.

Key Diagnostic Features

To accurately diagnose a cyclophosphamide allergy, clinicians should look for the following key features:

• Clinical Assessment: A thorough medical history and physical examination are crucial in identifying patients at risk of allergic reactions to cyclophosphamide (1).
• Laboratory Tests: Blood tests can help confirm the presence of an immune-mediated response, such as elevated IgE levels or specific antibodies against cyclophosphamide (2).

References

(1) NA Finnigan. Differentiate allergic and drug-induced acute interstitial nephritis from other causes of acute kidney injury through clinical assessment, ...

(2) B Galateanu. In most cases, this is an IgE-mediated response, caused by the activation of mast cells by IgE, triggering synthesis and release by mast cells ...