title: Delayed hypersensitivity reaction related to the use of pegfilgrastim.
abstract: Filgrastim and pegfilgrastim are granulocyte colony-stimulating factor products, which have been part of the supportive treatment of cancer patients for years to increase the white blood cell count and absolute neutrophil count with the objective of preventing neutropenic fever in patients at risk because of chemotherapy. Pegfilgrastim is a glycosylated form of filgrastim with a prolonged duration of effect, a reduced renal clearance, and relatively fewer side effects. We present a patient with early breast cancer who developed a rash more than a week after the use of pegfilgrastim. Clinicians must be aware of the possibility of a delayed hypersensitivity reaction as the application of this drug is increasing and an adverse event can result in delay of chemotherapy treatment.
authors.affiliation: Dept. of Internal Medicine, University of Connecticut Health Center, Hartford, USA dadla@resident.uchc.edu.
authors.forename: Aliakbar
authors.initials: A
authors.lastname: Dadla
authors.affiliation: Dept. of Hematology Oncology, University of Connecticut Health Center, Farmington, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Tannenbaum
authors.affiliation: Dept. of Dermatology, University of Connecticut Health Center, Farmington, USA.
authors.forename: Breton
authors.initials: B
authors.lastname: Yates
authors.affiliation: Dept. of Pharmacy, University of Connecticut Health Center, Farmington, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Holle
mesh_terms: D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000188:drug therapy; D003875:Drug Eruptions / Q000473:pathology; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000209:etiology* / Q000473:pathology; D007958:Leukocyte Count; D008875:Middle Aged; D009503:Neutropenia / Q000517:prevention & control; D011092:Polyethylene Glycols; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012867:Skin / Q000473:pathology
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim
keywords: Allergic; neulasta; pegfilgrastim; rash; reaction