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Death from anaphylaxis to cisplatin: a case report
S Zweizig1, L D Roman, L I Muderspach
1Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles 90033.
Gynecologic Oncology
|April 1, 1994
Summary
A patient experienced fatal anaphylaxis despite precautions when treated with cisplatin for ovarian cancer recurrence. This highlights the severe risks of hypersensitivity reactions to platinum-based chemotherapy.
Area of Science:
- Oncology
- Clinical Pharmacology
- Toxicology
Background:
- Platinum-based chemotherapy, including cisplatin and carboplatin, is a cornerstone treatment for ovarian carcinoma.
- Hypersensitivity reactions (HSRs) to platinum agents can occur, ranging from mild symptoms to severe anaphylaxis.
- Patient presented with recurrent ovarian carcinoma, previously responsive to cisplatin.
Observation:
- The patient experienced a seizure during carboplatin treatment and was switched back to cisplatin.
- Despite premedication with antihistamines and steroids, the patient developed refractory anaphylactic shock after a low dose of cisplatin (400 micrograms).
- The anaphylactic reaction was not responsive to resuscitation efforts.
Findings:
- The reported incidence of cisplatin hypersensitivity ranges from 1% to 20%.
- Standard preventive measures, including premedication, single-agent chemotherapy, and slow infusion rates, were ineffective in this case.
- This case illustrates a rare but fatal outcome of cisplatin-induced anaphylaxis.
Implications:
- Clinicians should be aware of the potential for severe, refractory hypersensitivity reactions to cisplatin, even with preventive strategies.
- Further research may be needed to identify patients at higher risk for severe HSRs and to develop more effective management protocols.
- This case underscores the critical importance of vigilant monitoring during platinum-based chemotherapy administration.