2006
DOI: 10.1001/archderm.142.2.218
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Eosinophilic Cellulitislike Reaction to Subcutaneous Etanercept Injection

Abstract: Background: Injection site reactions are well recognized in patients treated with etanercept. Previous reports describe histologic findings of a cell-mediated T H 1 reaction, with CD8 ϩ T cells composing the majority of the dermal infiltrate. Observations: A pruritic, erythematous, edematous patch occurred on the right thigh of a 57-year-old white woman treated for rheumatoid arthritis within 12 to 24 hours after her second dose of subcutaneous etanercept. The patient had a similar reaction to adalimumab injec… Show more

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Cited by 75 publications
(42 citation statements)
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“…[1][2][3][4] ISRs are thought to be T lymphocyte-mediated delayed type IV hypersensitivity reactions, which may preclude subsequent medication administration. 5,6 Rapid drug desensitization protocols have been developed for the delivery of a variety of parenteral chemotherapeutic agents, including monoclonal antibodies, to sensitized patients. 7 However, desensitization protocols have not been standardized for the treatment of ISRs and systemic reactions following subcutaneous medication injections.…”
Section: To the Editormentioning
confidence: 99%
See 1 more Smart Citation
“…[1][2][3][4] ISRs are thought to be T lymphocyte-mediated delayed type IV hypersensitivity reactions, which may preclude subsequent medication administration. 5,6 Rapid drug desensitization protocols have been developed for the delivery of a variety of parenteral chemotherapeutic agents, including monoclonal antibodies, to sensitized patients. 7 However, desensitization protocols have not been standardized for the treatment of ISRs and systemic reactions following subcutaneous medication injections.…”
Section: To the Editormentioning
confidence: 99%
“…Some authors have suggested that reactions to TNF inhibitors may also have a T-cell inflammatory component. 5,6 Biopsies were not done for this study but are needed to further assess the mechanism of these reactions.…”
Section: Skin Testing and Desensitization Protocolsmentioning
confidence: 99%
“…While mostly of unclear etiology, it has been reported as a side effect of anti-TNF agents including infliximab [90], adalumimab [91], and etanercept [92], with positive delayed intradermal testing to adalimumab and etanercept reported [92].…”
Section: Wells' Syndrome (Eosinophilic Cellulitis)mentioning
confidence: 99%
“…Both types of reaction wane over time, which is though to represent a type of desensitization, although this may not be an accurate term in cases of CD8 þ T lymphocyte-mediated DTH responses [34]. Interestingly, there is a report of a patient who exhibited ISRs to adalimumab and subsequently developed an eosinophilic cellulitis-like ISR upon the first injection of etanercept [32]. The patient showed no skin-test reactivity to mannitol, a common constituent of the etanercept and adalimumab preparations.…”
Section: Hypersensitivity or Type B Reactions To Biological Agentsmentioning
confidence: 99%