title: Desensitization to Adalimumab: An Example of Repeated Desensitization to a Biological Agent.
abstract: Biological agents seem to have been more effective than classic immunosuppressive drugs; however, the adverse events including the hypersensitivity reactions are the main drawbacks of these drugs. We report a 35-year-old man who was treated with adalimumab for ankylosing spondylitis, had a local reaction on the injection site, and generalized itching with rash at the 62nd dose and repeated desensitizations to him with adalimumab. One month after the reaction, skin prick test was performed with a commercial preparation of adalimumab. The skin prick test result was determined positive comparing to positive and negative controls. Because of insufficient responses to other drugs, adalimumab desensitization was performed and the whole process was completed without any reaction. Six months later the patient gave up therapy because of a new reaction which was caused by a possible viral infection. Desensitization was repeated successfully 3 months later. Because there are few cases in the literature about adalimumab desensitization process, there is no standard desensitization protocol for the adalimumab allergy yet. Therefore, we suggest that our case report may contribute to the formation of a standardized desensitization protocol in adalimumab hypersensitivity.
authors.affiliation: Division of Immunology and Allergic Diseases, Department of Internal Medicine, Gulhane Military Medical Academy and Medical School, Etlik, 06018, Ankara, Turkey.
authors.forename: Fevzi
authors.initials: F
authors.lastname: Demirel
authors.affiliation: Division of Immunology and Allergic Diseases, Department of Internal Medicine, Gulhane Military Medical Academy and Medical School, Etlik, 06018, Ankara, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Kartal
authors.affiliation: Division of Immunology and Allergic Diseases, Department of Internal Medicine, Gulhane Military Medical Academy and Medical School, Etlik, 06018, Ankara, Turkey. mustafag@gata.edu.tr.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gulec
authors.affiliation: Division of Immunology and Allergic Diseases, Department of Internal Medicine, Gulhane Military Medical Academy and Medical School, Etlik, 06018, Ankara, Turkey.
authors.forename: Sait
authors.initials: S
authors.lastname: Yesillik
authors.affiliation: Division of Immunology and Allergic Diseases, Department of Internal Medicine, Gulhane Military Medical Academy and Medical School, Etlik, 06018, Ankara, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Baysan
authors.affiliation: Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy and Medical School, Ankara, Turkey.
authors.forename: Kutay
authors.initials: K
authors.lastname: Tezel
authors.affiliation: Division of Immunology and Allergic Diseases, Department of Internal Medicine, Gulhane Military Medical Academy and Medical School, Etlik, 06018, Ankara, Turkey.
authors.forename: Ugur
authors.initials: U
authors.lastname: Musabak
authors.affiliation: Division of Immunology and Allergic Diseases, Department of Internal Medicine, Gulhane Military Medical Academy and Medical School, Etlik, 06018, Ankara, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Sener