Atypical cytokine release syndrome induced by carboplatin: The first described case report

IntroductionHypersensitivity reactions to carboplatin include type I reactions, mixed reactions, and delayed reactions.Case reportWe report a case of an atypical cytokine release syndrome induced by carboplatin in a patient with breast carcinoma.Management & outcomeThe patient developed clinical manifestations consisting of a delayed cytokine release syndrome following administration of carboplatin and paclitaxel. To establish the diagnosis, she underwent a double desensitization protocol over two consecutive days with paclitaxel and carboplatin. A delayed elevation of interleukin-6 after carboplatin supported the diagnosis of an isolated cytokine release syndrome. The patient subsequently continued treatment with paclitaxel through standard infusions and with carboplatin using a desensitization protocol.DiscussionCytokine release syndrome associated with carboplatin has been previously reported as occurring immediately after infusion and as part of a mixed phenotype (type I and cytokine release). A delayed-onset cytokine release syndrome induced by carboplatin, occurring outside the context of a mixed reaction, is reported.ConclusionCytokine release syndrome may present as an isolated, delayed reaction following carboplatin infusion. Measurement of interleukin-6 may be a valuable diagnostic tool for confirming the diagnosis of cytokine release syndrome.