Oxaliplatin延遲性過敏反應之案例報告

Case Reports: Delayed Hypersensitivity Reactions to Oxaliplatin

鄭吉元(Chi-Yuan Cheng) ； 陳琦華(Chi-Hua Chen) ； 陳偉立(Weili Chen) ； 鄧新棠(Shin-Tarng Deng)

《臺灣臨床藥學雜誌》 22卷2期 (2014/06) Pp. 95-100

https://doi.org/10.6168/FJCP.2014.2202.04

摘要

Oxaliplatin引起過敏反應的發生率約10%至20%，通常發生在給藥過程中或是注射完後立即發生，其過敏症狀多樣呈現且大多輕微，但是也可能會有威脅生命的嚴重過敏發生。本文報告兩位因使用oxaliplatin而引起延遲性過敏反應之案例。病人是大腸癌患者住院施打輔助性化療藥物處方FOLFOX（Folinic acid/Fluorouracil/Oxaliplatin）。兩位案例皆發生3次延遲性過敏反應。過敏反應發生的時間是在oxaliplatin注射已結束後平均8.5小時（6~12小時）。此延遲性過敏反應最常見的症狀是只有發燒，當給予抗過敏針劑diphenhydramine後體溫很快就降為正常值。這兩個案例使用Naranjo score評分判定皆為極有可能因oxaliplatin引起之延遲性過敏反應。由案例中也發現在注射oxaliplatin之前先給予注射diphenhydramine再加上延長oxaliplatin輸注時間至4小時，可預防oxaliplatin 引發再次過敏反應的發生。

關鍵字

大腸癌 ； 延遲性過敏反應 ； 發燒

並列摘要

We reported 2 cases of delayed hypersensitivity reactions (HSRs) to oxaliplatin. Both patients had colon cancer and received adjuvant combination chemotherapy with the FOLFOX (Folinic acid/Fluorouracil/ Oxaliplatin) regimen. Each patient experienced 3 episodes (total 6 episodes) of delayed HSrs to oxaliplatin. On average, HSRs developed 8.5 hours (ranging from 6 to 12 hours) after complete infusion of oxaliplatin. Fever was the most common presentation of this delayed-type hypersensitivity in our patients. In all febrile occasions, fever subsided shortly after administering an antihistamine. The association of HSRs and oxaliplatin was high according to evaluation by the Naranjo score. In our experience, such delayed HSRs may be prevented by antihistamine prophylaxis and prolonged infusion time (up to 4 hours) of oxaliplatin.

並列關鍵字

Oxaliplatin ； Colon Cancer ； Delayed Hypersensitivity Reaction ； Fever ； Diphenhydramine