title: A Safe and Novel Desensitization Protocol with Ferric Carboxymaltose to Treat Iron Deficiency Anemia.
abstract: BACKGROUND
  Worldwide, iron deficiency anemia is the most common nutritional disorder. Treatment with oral iron supplementation may not be well tolerated due to gastrointestinal side effects. Therapy with Intravenous (IV) iron supplementation is more effective and better tolerated, especially in patients with underlying Inflammatory Bowel Disease (IBD) or malignancy. However, Hypersensitivity Reactions (HSR) and anaphylaxis to IV iron have been described.
  
  
  METHODS
  We evaluated the literature and developed an eleven step desensitization protocol for ferric carboxymaltose to be administered in high risk patients.
  
  
  RESULTS
  We present the first case series demonstrating the safety of ferric carboxymaltose desensitization in patients with a history of anaphylaxis to IV iron and iron deficiency anemia.
  
  
  CONCLUSIONS
  While there are many IV iron formulations available, ferric carboxymaltose can replenish iron stores with fewer doses. Ferric carboxymaltose is contraindicated in patients with prior hypersensitivity reactions to iron formulations. This novel eleven step desensitization protocol was well tolerated without any adverse reactions and allowed the patients to receive iron supplementation when limited therapeutic options existed.
authors.forename: Shari V
authors.initials: SV
authors.lastname: Montandon
authors.forename: Merritt L
authors.initials: ML
authors.lastname: Fajt
authors.affiliation: UPMC Montefiore, NW 628, 3459 Fifth Avenue, Pittsburgh, PA 15213, USA. petrovaa@upmc.edu.
authors.forename: Andrej A
authors.initials: AA
authors.lastname: Petrov
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008320:Maltose / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D005290:Ferric Compounds; C522335:ferric carboxymaltose; D008320:Maltose