Abstract

RODOLFO, Ana; FRIOES, Fernando  and  CERNADAS, Josefina R.. Immediate hypersensitivity to an emergency drug - New successful amiodarone dessensitization protocolo. Rev Port Imunoalergologia [online]. 2020, vol.28, n.3, pp.173-175. ISSN 0871-9721.  https://doi.org/10.32932/rpia.2020.09.041.

A 71-year-old male was admitted to the emergency room for dyspnea, thoracic pain and palpitations, where he was diagnosed with atrial flutter (AFL) with rapid ventricular rate (RVR), and was treated with bisoprolol, digoxine and verapamil. Because the RVR persisted, an amiodarone perfusion was started, during which an immediate episode of generalized urticaria occurred. The patient had a history of urticaria during an infusion of amiodarone in a previous episode of AFL with RVR. Although he was already medicated with digoxin and bisoprolol, he was still at high risk of RVR. Due to the reproducible immediate reactions to amiodarone, and the fact that amiodarone was the only therapeutic option, a 13-step desensitization protocol was designed, starting with an initial dose of 0.03 mg/mL (1/10 000 of the target cumulative dose) and ending with a final dose of 300 mg. The desensitization was successfully performed, without any immediate or late reactions. Then, a 200 mg oral daily dose was kept in order to maintain the desensitization state.

Keywords : Amiodarone; drug desensitization; emergency drug allergy.

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