Anaphylaxis after treatment with recombinant factor VIII: investigation and therapeutic challenge

Sofia Pires; Teresa Sevivas; Carla Chaves Loureiro; Borja Bartholomé

doi:10.1136/bcr-2018-227426

Anaphylaxis after treatment with recombinant factor VIII: investigation and therapeutic challenge

BMJ Case Rep. 2018 Dec 14;11(1):e227426. doi: 10.1136/bcr-2018-227426.

Authors

Sofia Pires¹, Teresa Sevivas², Carla Chaves Loureiro¹, Borja Bartholomé³

Affiliations

¹ Pediatric Department, Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
² Haematology Department, Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
³ Application Lab, R&D Department, Roxall Group, Bilbao, Spain.

Abstract

We report a 10-year-old patient with haemophilia A developing anaphylaxis to recombinant factor VIII (octocog alfa). Allergic reactions, and especially anaphylactic events, are rare in patients with haemophilia A. The nature of these reactions is not fully understood. Here, we demonstrate a type I hypersensitivity reaction using sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunoblotting assay. This test revealed itself as an essential diagnostic tool, as it allowed us to choose an alternative treatment (moroctocog alfa). Its safety was later confirmed by an uneventful challenge test.

Keywords: paediatrics (drugs and medicines); unwanted effects/adverse reactions.

Publication types

Case Reports

MeSH terms

Anaphylaxis / chemically induced*
Child
Factor VIII / administration & dosage
Factor VIII / adverse effects*
Factor VIII / therapeutic use
Finger Injuries / drug therapy*
Hematoma
Hemophilia A / drug therapy*
Humans
Male
Treatment Outcome

Substances

recombinant factor VIII SQ
Factor VIII