title: Hypersensitivity reaction to a metabolite of cyclophosphamide.
abstract: Generalized urticaria and fever were noted in a patient with IgA (kappa) myeloma after intravenous cyclophosphamide. Intradermal skin testing revealed no reaction to cyclophosphamide and its analog, isophosphamide. However, phosphoramide mustard, a principle metabolite of cyclophosphamide, evoked an immediate wheal-and-flare response. Subsequent therapy with isophosphamide was well tolerated. These findings suggest that acute hypersensitivity reactions to cyclophosphamide are due to its metabolites and can be delineated with skin testing.
mesh_terms: D003520:Cyclophosphamide / Q000009:adverse effects* / Q000378:metabolism / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D006632:Histamine / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000031:analogs & derivatives; D007428:Intradermal Tests; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy; D010752:Phosphoramide Mustards
chemical_list: D010752:Phosphoramide Mustards; C027061:isophosphamide mustard; D006632:Histamine; D003520:Cyclophosphamide; D007069:Ifosfamide