title: Late-onset anaphylactic reactions following i.v. cyclophosphamide pulse in a patient with systemic sclerosis and systemic lupus erythematosus overlap syndrome.
abstract: Late-onset anaphylactic reaction is a rare adverse effect of i.v. cyclophosphamide pulse (IVCY), which is caused by cyclophosphamide metabolites. We herein report a case of scleroderma and lupus overlap syndrome who developed anaphylactic reactions 3 h to 4 days after IVCY. Long time lapses between IVCY and appearance of symptoms are compatible with type I hypersensitivity to cyclophosphamide metabolites, appearing as late-onset anaphylactic reaction. Albeit unusual, this is an important anaphylactic reaction to be aware of following IVCY.
authors.affiliation: Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Asano
authors.forename: Zenshiro
authors.initials: Z
authors.lastname: Tamaki
authors.forename: Takehiro
authors.initials: T
authors.lastname: Takahashi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Ichimura
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Toyama
authors.forename: Shinji
authors.initials: S
authors.lastname: Kagami
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mitsui
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sato
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced*; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008875:Middle Aged; D020551:Pulse Therapy, Drug; D012595:Scleroderma, Systemic / Q000188:drug therapy*
chemical_list: D018501:Antirheumatic Agents; D003520:Cyclophosphamide
keywords: cyclophosphamide; interstitial lung disease; late-onset anaphylactic reactions; systemic lupus erythematosus; systemic sclerosis