title: Vitreous injections of pegaptanib sodium triggering allergic reactions.
abstract: OBJECTIVE
  To report two cases of systemic allergic response associated with vitreous administration of pegaptanib sodium.
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  Two patients were treated for systemic allergic reactions associated with the administration of pegaptanib sodium.
  
  
  RESULTS
  One patient developed a delayed and prolonged anaphylactoid reaction following administration of his first dose of intraocular pegaptanib sodium. The second patient received four injections of pegaptanib over the course of six months. He developed mild lip swelling and prolonged urticarial rash following the first injection, which subsided when pegaptanib was suspended.
  
  
  CONCLUSIONS
  Severe hypersensitivity reactions may occur in association with vitreous administration of pegaptanib sodium and may be associated with prolonged urticaria and angioedema. Elderly individuals with comorbidities are at higher risk for fatality from severe hypersensitivity reactions in the ambulatory setting. Physicians administering pegaptanib sodium should review emergency response and airway procedures.
authors.affiliation: Center for Macular Degeneration and Department of Ophthalmology and Visual Sciences, The University of Iowa Carver College of Medicine, Iowa City, Iowa 52242, USA.
authors.forename: Andrew C G
authors.initials: AC
authors.lastname: Steffensmeier
authors.forename: Antoine E
authors.initials: AE
authors.lastname: Azar
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Fuller
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Muller
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Russell
mesh_terms: D000369:Aged, 80 and over; D000707:Anaphylaxis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D052157:Aptamers, Nucleotide / Q000009:adverse effects*; D020256:Choroidal Neovascularization / Q000188:drug therapy; D004155:Diphenhydramine / Q000008:administration & dosage; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage; D006801:Humans; D007267:Injections; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D014581:Urticaria / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014822:Vitreous Body
chemical_list: D020533:Angiogenesis Inhibitors; D052157:Aptamers, Nucleotide; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C495058:pegaptanib; D004155:Diphenhydramine; D008775:Methylprednisolone; D004837:Epinephrine