title: [Castleman's disease: Rapid desensitization for hypersensitivity reaction to rituximab].
abstract: BACKGROUND
  Rapid desensitization allows secure administration of a drug and is indicated when there is no therapeutic alternative.
  
  
  METHODS
  We report a 49-year-old patient who presented with a hypersensitivity reaction following an infusion of rituximab (375mg/m(2)) in the context of a Castleman's syndrome. After a clinical flare (splenomegaly, adenopathies) despite treatment with tocilizumab, anakinra and valganciclovir, the reintroduction of rituximab was decided, according to the rapid desensitization protocol. Four full dose desensitizations were successfully performed allowing immediate clinical improvement (apyrexia, loss of sweating and lymphadenopathy, splenomegaly partial regression) and biological (negativation of HHV8 viral load, and disappearance of neutropenia, anemia and thrombocytopenia).
  
  
  CONCLUSIONS
  Rapid desensitization is a promising method for the pursuit of rituximab therapy after a hypersensitivity reaction and should be considered in patients with no acceptable therapeutic alternative.
authors.affiliation: Service de pharmacie-stérilisation, GHR Mulhouse et Sud-Alsace, 68070 Mulhouse, France. Electronic address: christopher.boin@ch-mulhouse.fr.
authors.forename: C
authors.initials: C
authors.lastname: Boin
authors.affiliation: Service de pharmacie-stérilisation, GHR Mulhouse et Sud-Alsace, 68070 Mulhouse, France.
authors.forename: S
authors.initials: S
authors.lastname: Lambert
authors.affiliation: Service de pharmacie-stérilisation, GHR Mulhouse et Sud-Alsace, 68070 Mulhouse, France.
authors.forename: P
authors.initials: P
authors.lastname: Thomann
authors.affiliation: Service de pharmacie-stérilisation, GHR Mulhouse et Sud-Alsace, 68070 Mulhouse, France.
authors.forename: O
authors.initials: O
authors.lastname: Aujoulat
authors.affiliation: Unité de médecine interne, GHR Mulhouse et Sud-Alsace, 20, rue du Dr Laennec, 68070 Mulhouse cedex, France. Electronic address: kiefferp@ch-mulhouse.fr.
authors.forename: P
authors.initials: P
authors.lastname: Kieffer
mesh_terms: D005871:Castleman Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D003888:Desensitization, Immunologic; D003937:Diagnosis, Differential; D004342:Drug Hypersensitivity / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069283:Rituximab / Q000009:adverse effects*
chemical_list: D000069283:Rituximab
keywords: Anticorps monoclonaux; Desensitization; Désensibilisation; Hypersensitivity reaction; Monoclonal antibodies; Rituximab; Réaction d’hypersensibilité