title: Immediate cross-hypersensitivity between micafungin and caspofungin: a case report.
abstract: A hematopoietic stem cell transplant patient with a history of immediate drug hypersensitivity reaction to micafungin was considered for a caspofungin trial. A caspofungin intradermal skin test was performed. The result was positive, suggesting the presence of cross-reactivity and that the cyclic peptide nucleus chemical structure shared between echinocandins is the site of IgE recognition. It is recommended to avoid challenging patients with history of immediate hypersensitivity to one echinocandin with another.
authors.affiliation: Wayne State University, Detroit, MI, USA.
authors.forename: Shruti
authors.initials: S
authors.lastname: Patel
authors.forename: George J
authors.initials: GJ
authors.lastname: Alangaden
authors.forename: Larry G
authors.initials: LG
authors.lastname: Lum
authors.forename: Simon M
authors.initials: SM
authors.lastname: Cronin
authors.forename: Muneer H
authors.initials: MH
authors.lastname: Abidi
authors.forename: Natalie
authors.initials: N
authors.lastname: Dieterle
authors.forename: Rami B
authors.initials: RB
authors.lastname: Ibrahim
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000009:adverse effects / Q000276:immunology*; D000077336:Caspofungin; D003429:Cross Reactions; D004342:Drug Hypersensitivity / Q000276:immunology*; D054714:Echinocandins / Q000009:adverse effects / Q000276:immunology*; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000139:chemically induced*; D055666:Lipopeptides / Q000009:adverse effects / Q000276:immunology*; D000077551:Micafungin; D012882:Skin Tests
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077336:Caspofungin; D000077551:Micafungin