title: Anaphylactic Shock at the End of Hemodialysis.
abstract: Allergic reactions to epoetin alfa, including anaphylaxis, have been described but desensitization in the setting of an IgE-mediated reaction has not been reported. We present a case of a hemodialysis patient who developed symptoms of an IgE-mediated allergic response to epoetin alfa that occurred after each administration. These reactions progressed to a single episode of anaphylaxis with generalized pruritus, urticaria, oropharyngeal edema, and hypotension that prompted its discontinuation. Intradermal skin testing confirmed an allergic response to this agent. The patient then underwent a desensitization procedure to epoetin alpha after which she was able to tolerate it without further problems.
authors.affiliation: Section of Nephrology, Department of Medicine, Rush University Medical Center, Chicago, Illinois.
authors.forename: Nivin
authors.initials: N
authors.lastname: Aziz
authors.affiliation: Section of Allergy and Immunology, Department of Immunology & Microbiology, Rush University Medical Center, Chicago, Illinois.
authors.forename: Carla
authors.initials: C
authors.lastname: Luna
authors.affiliation: Section of Allergy and Immunology, Department of Immunology & Microbiology, Rush University Medical Center, Chicago, Illinois.
authors.forename: Farheen
authors.initials: F
authors.lastname: Mirza
authors.affiliation: Section of Allergy and Immunology, Department of Immunology & Microbiology, Rush University Medical Center, Chicago, Illinois.
authors.forename: Mary
authors.initials: M
authors.lastname: Tobin
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D006801:Humans; D007113:Immunity, Innate; D007676:Kidney Failure, Chronic / Q000628:therapy*; D006435:Renal Dialysis / Q000009:adverse effects*; D012882:Skin Tests