A case report of allergy to exenatide

Perez, Eva; Martinez-Tadeo, Juan Antonio; Callero, Ariel; Hernández, G; Rodríguez-Plata, Elena; García-Robaina, José Carlos

doi:10.1016/j.jaip.2014.05.011

Cited by 12 publications

(8 citation statements)

References 5 publications

(6 reference statements)

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“…Moreover, discontinuous treatment in our study may increase the risk of anaphylaxis. This is consistent with the second study that intermittent treatment of exenatide has developed an allergy, [8] the possible cause is immunoglobulin E-mediated degranulation of mast cells. [9] In addition, although off-label dose of exenatide in our study was mentioned, exenatide overdose has no clinical harm.…”

Section: Discussionsupporting

confidence: 91%

“…[ 7 ] The second is a patient that suffered from generalized urticaria, and difficulty swallowing after the administration of exenatide. [ 8 ] Although the third study reported an exenatide treatment with no allergic reactions because of well tolerated exenatide, the patient was allergic to exenatide by skin prick test and intradermal skin test, with the probable cause that drug skin test results was not always consistent with the clinical effects. [ 9 ] The positive skin tests in all these studies and a basophil activation test with positive results in the first study forcefully supported an immunoglobulin E-mediated mechanism.…”

Section: Discussionmentioning

confidence: 99%

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A case report of severe adverse reaction of exenatide: Anaphylactic shock

Liu¹,

Zhai²,

Zhang³

2022

Medicine

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Background: Anaphylactic shock is the severe state of the allergic reaction, which is rapid in onset and fatal. This is the first study that discusses the anaphylactic shock of exenatide reexposure in the patient who has interrupted exenatide treatment. Patient concerns: A 47-year-old man was treated with exenatide owing to high blood glucose and obesity. Then he developed localized urticarial on the face, white lip, hands tremble, nausea, vomit, chest stuffiness, dizziness, accompanying with confusion and dyspnea. His blood glucose was 4.6 millimole per liter (mmol/L) and blood pressure was 85/50 millimeters of mercury (mm Hg). Diagnosis: Exenatide-induced anaphylactic shock was considered. Interventions: The emergency electrocardiogram was performed. The patient was treated with dexamethasone sodium phosphate and calcium gluconate, combined with exenatide withdrawal. He also received oral antiallergic agents and intravenous nutrition treatment. Outcomes: After antishock treatment, the clinical response gradually alleviated. Lessons: Although exenatide is not prone to anaphylaxis, it is the synthetic peptide that can induce antibody formation. Exenatide has immunogenicity with the potential to elicit an allergic reaction upon administration. Clinicians should always pay more attention to the anaphylactic shock of exenatide, when prescribing for diabetics.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

A case report of severe adverse reaction of exenatide: Anaphylactic shock

Liu¹,

Zhai²,

Zhang³

2022

Medicine

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show abstract

“…Antibody-positive patients were reported to be more likely to have injection site reactions (all mild and transient), with no associations with systemic hypersensitivity reactions, which are considered extremely rare [8]. To our knowledge, there have only been 2 reports of systemic hypersensitivity reactions to exenatide, namely, one of generalized urticaria and dysphagia with exenatide [9] and another of generalized urticaria and dyspnea with LAR exenatide, both of which were immediate [10]. In both cases, skin tests were positive for the drug involved, and a BAT performed in the second case yielded a negative result.…”

mentioning

confidence: 97%

Anaphylaxis to Long-Acting Release Exenatide

Ornelas

Caiado

Lopes

et al. 2018

J Investig Allergol Clin Immunol

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“…A literature review of allergy to GLP-1RA has yielded five reports, all concerning exenatide. Two such reports were published by Pérez et al (2) and Ornelas et al (3). Reactions consisted mainly of urticaria, pruritus, and dyspnea.…”

mentioning

confidence: 97%

“…The mechanism of allergy to exenatide was described as IgE mediated (2). This immune response was demonstrated by basophil activation tests (3) and related to exenatide's nonhuman origin (2).…”

mentioning

confidence: 99%