Anaphylactic Reaction to Recombinant Human Erythropoietin

Hypersensitivity reactions to the polysorbate contained in recombinant erythropoietin and darbepoietin (Case Report)

“…Reactions to erythropoietin and possibly its excipients have previously been described in the literature. Garcia and colleagues describe a patient who had anaphylaxis after an erythropoietin infusion 3 . Skin testing was negative, but specific immunoglobulin E antibodies to recombinant human erythropoietin were detected.…”

“…Garcia and colleagues describe a patient who had anaphylaxis after an erythropoietin infusion. 3 Skin testing was nega- tive, but specific immunoglobulin E antibodies to recombinant human erythropoietin were detected. Similarly, a generalized eczematous reaction to erythropoietin beta was reported, although skin, patch and erythropoietin autoantibody testing was negative.…”

Failure of Human Immunoresponse to N-Glycolylneuraminic Acid Epitope Contained in Recombinant Human Erythropoietin

“…no antibody against rHuEPO has been detected by a highly sensitive enzyme immunoassay and/or radioimmunoassay in sera from 6,300 patients who received successive injections of rHuEPO [3]. Recently, one case was reported by Garcia et al [4] that a patient produced rHuEPO-specific IgE anti body, but it is still unknown whether its antigenic epitope is either a carbohydrate or a peptide. Elucidation of the antibody binding site to rHuEPO will be important in fur ther studies.…”

“…Recently, however, an anaphylac tic reaction to rHuEPO look place in one Spanish patient during intravenous administration and where rHuEPOspecific IgE antibody was detected [4], One of the antigenic determinants in rHuEPO may be Neu5Gc. Indeed, the immunization of chickens (who like humans do not synthesize Neu5Gc) with rHuEPO led to a production of low titer antibody against Neu5Gc epitope [5], Human cancerous tissues and some chicken lympho mas express Neu5Gc in their sialoglycoconjugates, and this expression frequently stimulates the production of the so-called Hanganutziu-Deicher (HD) antibody which recognizes Neu5Gc moiety of the sialoglycoconjugates [6,7].…”

Anaphylactic Shock at the End of Hemodialysis

“…Mild allergic reactions to erythropoiesis-stimulating agents (ESAs) have been described. Even more unusual are anaphylactic reactions following ESA administration, with the timing and severity suggesting the mechanism to be an allergic hypersensitivity reaction (1)(2)(3). We report the first case of a patient to receive successful desensitization after development of anaphylaxis to epoetin alfa.…”