Intravenous Immunoglobulin Therapy-Induced Erythema Multiforme in a Patient with Chronic Lymphocytic Leukemia.

IF 0.9 Q4 DERMATOLOGY Case Reports in Dermatology Pub Date : 2023-10-16 eCollection Date: 2023-01-01 DOI:10.1159/000533987
Angelina Konovalova, Natālija Gerula, Ilona Hartmane, Ilze Upeniece, Mihails Ščerbuks, Kristīne Bernāte, Lelde Reinberga, Ingmārs Mikažāns
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Abstract

This case report discusses immunoglobulin-induced erythema multiforme (EM), a rare and understudied condition that requires further investigation. The report presents the case of a 69-year-old woman with a history of chronic lymphocytic leukemia who developed an acute hypersensitivity reaction to intravenous gamma globulin medication. The patient received intravenous immunoglobulin (IVIG) to normalize and stabilize her immunoglobulin levels and reduce the risk of recurrent infections due to her immunodeficiency with predominantly antibody defects. However, after the second administration of the medication, the patient experienced an acute skin rash and was admitted to the hospital for treatment. The treatment plan included systemic desensitizing therapy, systemic antihistamine therapy, corticosteroid therapy, and local therapy. After a course of therapy, the patient's skin condition improved, and her overall well-being improved. However, due to the acute hypersensitivity reaction, the IVIG therapy was discontinued. The multidisciplinary team of specialists concluded that the patient had developed EM. The discussion provides an overview of EM, including its causes, clinical presentation, diagnostic tools, and therapy principles. The discussion also describes the use of human IVIG preparations in treating various immunodeficient and inflammatory diseases, highlighting the importance of monitoring patients for adverse effects. The case of this patient underscores the potential risks associated with immunoglobulin therapy and emphasizes the need for healthcare providers to remain vigilant for adverse reactions. By promptly diagnosing and treating EM, healthcare providers can minimize its impact on patients' overall well-being.

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静脉注射免疫球蛋白治疗慢性淋巴细胞白血病患者诱发多发性红斑。
本病例报告讨论了免疫球蛋白诱导的多形性红斑(EM),这是一种罕见且研究不足的情况,需要进一步研究。该报告介绍了一例69岁女性,有慢性淋巴细胞白血病病史,对静脉注射丙种球蛋白药物产生急性超敏反应。患者接受了静脉注射免疫球蛋白(IVIG),以使其免疫球蛋白水平正常化和稳定,并降低因免疫缺陷(主要是抗体缺陷)而复发感染的风险。然而,在第二次给药后,患者出现急性皮疹,并入院接受治疗。治疗方案包括全身脱敏治疗、全身抗组胺治疗、皮质类固醇治疗和局部治疗。经过一个疗程的治疗,患者的皮肤状况有所改善,整体健康状况也有所改善。然而,由于急性超敏反应,IVIG治疗被终止。多学科专家团队得出结论,患者已患EM。讨论概述了EM,包括其病因、临床表现、诊断工具和治疗原则。讨论还描述了人类IVIG制剂在治疗各种免疫缺陷和炎症疾病中的应用,强调了监测患者不良反应的重要性。该患者的病例强调了免疫球蛋白治疗的潜在风险,并强调了医疗保健提供者对不良反应保持警惕的必要性。通过及时诊断和治疗EM,医疗保健提供者可以最大限度地减少其对患者整体健康的影响。
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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
57
审稿时长
9 weeks
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