Acute Exacerbation of Ankylosing Spondylitis After an Iron Dextran Infusion

Serum Sickness from Iron-Dextran Administration

“…The most common hypersensitivity reaction, occurring in over 30% of patients given iron dextran, is the development of arthralgias and fever within 24-48 h after initiation of the intravenous ther apy [9][10][11][12], Other rare systemic hypersensitivity reac tions that occur 1 -2 weeks after initiation of iron-dex tran therapy have been reported. These reactions in clude generalized lymphadenopathy, general malaise, fever, elevated erythrocyte sedimentation rates, leu kocytosis with neutrophilia, splenomegaly and arthralgia/arthritis -similar to that reported in human serum sickness to heterologous proteins [4,[17][18][19][20][21][22], There is only one citation o f 'allergic purpura' to irondextran, but the lesions appeared within 24-48 h, and no biopsy was performed [23]. In this case, the patient received the iron-dextran and 9 days later developed 'palpable purpura', revealing a leukocytoclastic vas culitis that is consistent with a serum sickness reaction to exogenous antigen, i.e.…”