Four Cases of Cetuximab-Induced Anaphylactic Shock: Possible Avoidance of the Reaction by Prior Examination of Anti-IgE Antibody against Galactose-α-1,3-galactose

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  • Chinuki Yuko
    Department of Dermatology, Shimane University Faculty of Medicine
  • Ito Kazuyuki
    Department of Otolaryngology - Head and Neck Surgery, Matsue Red Cross Hospital
  • Takeda Makiko
    Department of Otolaryngology - Head and Neck Surgery, Matsue Red Cross Hospital
  • Takeuchi Kaoru
    Department of Otolaryngology - Head and Neck Surgery, Matsue Red Cross Hospital
  • Takahashi Hitoshi
    Department of Dermatology, Shimane University Faculty of Medicine
  • Morita Eishin
    Department of Dermatology, Shimane University Faculty of Medicine

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Other Title
  • セツキシマブによるアナフィラキシーショックの4例―α-gal特異的IgE検出による回避の可能性―
  • 速報的小論文 セツキシマブによるアナフィラキシーショックの4例 : α-gal特異的IgE検出による回避の可能性
  • ソクホウテキ ショウロンブン セツキシマブ ニ ヨル アナフィラキシーショック ノ 4レイ : a-gal トクイテキ IgE ケンシュツ ニ ヨル カイヒ ノ カノウセイ

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We experienced four patients with cetuximab-induced anaphylactic shock. The diagnosis of infusion reaction was primary given for them. Three of them had beef-specific IgE in their sera, and one of these three also had a history of flounder roe allergy, but none of them had a history of beef allergy. Anti-IgE antibodies against cetuximab and galactose-α-1,3-galactose (α-gal) were detected in the sera of all the patients by IgE-western blotting and CAP-FEIA. These data suggest that the causative allergen of the cetuximab-induced anaphylactic shock was α-gal. We previously reported that clinicians should be aware of the possibility of cetuximab-induced allergy in the patients with red meat and/or flounder roe allergy because of their cross reactivity. The cases presented here confirm our above mentioned reports. Prior testing for anti-IgE antibodies against red meat, cetuximab, and α-gal could possibly prevent cetuximab-induced allergic reactions.

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