Oral iron cutaneous adverse reaction and successful desensitization.
BACKGROUND
The oral administering of iron preparations sometimes produces adverse gastrointestinal effects. In contrast, cutaneous reactions are extremely rare.


OBJECTIVE
We report a patient with several episodes of generalized pruritus and erythematous maculopapular eruption after receiving oral compounds of iron and on whom desensitization with oral iron was attempted.


METHODS
We studied a female with microcytic anemia due to gynecologic blood loss who presented several episodes of cutaneous eruption after receiving oral compounds of iron. Skin prick-test and two simple-blind, placebo-controlled oral challenges were performed with various iron compounds, and finally desensitization with oral iron was carried out.


RESULTS
Skin prick-test and patch-test with iron preparations were negative. Two simple-blind, placebo-controlled oral challenges were performed and the patient began experiencing similar cutaneous symptoms. We started a slow desensitization protocol using increasing doses until the target amount of the drug was tolerated without adverse effects. The chronic administration of oral iron therapy once a day for 9 months sustained the desensitized state and the anemia disappeared.


CONCLUSIONS
We present methods to effectively manage iron supply for a microcytic anemia patient with cutaneous reactions due to oral iron compounds, to avoid repeated transfusions, slow desensitization with oral iron was successfully attempted.
Ortega
N
N
Department of Allergy, Hospital Ntra Sra del Pino, Las Palmas de G C Spain. nortega@correo.hpino.rcanaria.es
Castillo
R
R
Blanco
C
C
Alvarez
M
M
Carrillo
T
T
D000284:Administration, Oral; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy; D003875:Drug Eruptions / Q000209:etiology*; D005260:Female; D006801:Humans; D007501:Iron / Q000009:adverse effects*; D016037:Single-Blind Method
D007501:Iron