Anaphylactic reactions following infusion of factor VIII in a patient with classic hemophilia.
A 28 year old white man with hemophilia A had, for several years, been successfully maintained on a home care program utilizing self-administration of factor VIII concentrates, but one such infusion resulted in severe anaphylaxis. An immunoglobulin E (IgE)-mediated hypersensitivity response was demonstrated by (1) the release of histamine from the patient's basophils in vitro upon challenge with several different lots of factor VIII concentrate; (2) immediate cutaneous response to commercial factor VIII, factor IX and cryoprecipitate; and (3) measurement of IgE antibodies against a commercial factor VIII preparation. A subsequent life-threatening hemorrhage required cautious infusion of another commercial lot of factor VIII concentrate. Despite pretreatment with antiallergic drugs and attempted desensitization, a moderately severe anaphylactic reaction was observed.
D000328:Adult; D000707:Anaphylaxis / Q000276:immunology*; D001491:Basophils / Q000276:immunology; D005169:Factor VIII / Q000276:immunology* / Q000627:therapeutic use; D006467:Hemophilia A / Q000276:immunology / Q000628:therapy*; D006636:Histamine Release; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D008407:Mast Cells / Q000276:immunology
D007073:Immunoglobulin E; D005169:Factor VIII