title: Anaphylaxis and superior vena cava thrombus in a pediatric patient with acute lymphoblastic leukemia.
abstract: Pediatric patients with malignancies are at significant risk for complications from their underlying condition and medical therapy. Emergency medicine physicians must be quick to suspect life-threatening events, which can present insidiously. We describe a case of anaphylaxis and superior vena cava syndrome in an 18-year-old female patient after polyethylene glycol-conjugated asparaginase chemotherapy for acute lymphoblastic leukemia. Pertinent literature surrounding risk factors, diagnosis, and treatment is also reviewed.
authors.affiliation: Department of Pediatric Critical Care, University of Alabama at Birmingham, USA. acree1@lsuhsc.edu
authors.forename: Amy M
authors.initials: AM
authors.lastname: Creel
authors.forename: David
authors.initials: D
authors.lastname: Crawford
authors.forename: Priya
authors.initials: P
authors.lastname: Prabhakaran
mesh_terms: D000293:Adolescent; D000707:Anaphylaxis / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001215:Asparaginase / Q000008:administration & dosage / Q000009:adverse effects; D004636:Emergency Service, Hospital; D004638:Emergency Treatment; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D010690:Phlebography; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000188:drug therapy; D018570:Risk Assessment; D013927:Thrombosis / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging*; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D011092:Polyethylene Glycols; D014750:Vincristine; C042705:pegaspargase; D006493:Heparin; D001215:Asparaginase