Drug-eluting coronary stents: hypersensitivity reactions to paclitaxel. A case report.
BACKGROUND
Drug-eluting stents become increasingly popular for the treatment of coronary artery disease. Consequently, side effects including hypersensitivity reactions have to be anticipated.


METHODS
Here we report on a patient with an anaphylactic reaction 2 weeks after implantation of a polymer-based paclitaxel-eluting stent (Taxus, Boston Scientific). The patient presented with disseminated wheals, pruritus, bronchial asthma and acute synovitis. The reaction was successfully treated with initial intravenous injection followed by oral antihistamine treatment for 1 month until all stent-bound paclitaxel was assumed to be eluted. Thereafter no further anaphylactic reaction occurred.


CONCLUSIONS
This sequence of events points towards a causal relation of the stent implantation and hypersensitivity reaction with a central role of paclitaxel. The increasing use of this type of stent should therefore be carefully monitored for such adverse reactions.
Pfoch
L
L
Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany.
Mahler
V
V
Sticherling
M
M
D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced*; D018926:Anti-Allergic Agents / Q000008:administration & dosage; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003327:Coronary Disease / Q000188:drug therapy / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control*; D004342:Drug Hypersensitivity / Q000209:etiology*; D054855:Drug-Eluting Stents; D006634:Histamine H1 Antagonists / Q000008:administration & dosage; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000009:adverse effects*; D016896:Treatment Outcome
D018926:Anti-Allergic Agents; D002317:Cardiovascular Agents; D006634:Histamine H1 Antagonists; D017239:Paclitaxel