{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T22:41:35Z","timestamp":1694644895428},"reference-count":5,"publisher":"Colegio Mexicano de Inmunologia Clinica y Alergia, A. C.","issue":"3","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Alerg Mex"],"abstract":"<jats:p>Introducci\u00f3n: El rituximab es un anticuerpo monoclonal quim\u00e9rico Anti-CD20, siendo tratamiento de enfermedades linfoproliferativas y trastornos reumatol\u00f3gicos; las reacciones de hipersensibilidad (RHS) se asocian con la infusi\u00f3n, liberaci\u00f3n de citocinas, tipo I (IgE\/no-IgE), mixtas, tipo III y IV. La desensibilizaci\u00f3n busca inducir tolerancia temporal disminuyendo probabilidad de manifestaciones cl\u00ednicas mediante administraci\u00f3n gradual de dosis total del medicamento, siendo c\u00e9lulas blanco del procedimiento, bas\u00f3filos y mastocitos, previniendo su activaci\u00f3n.\nReporte de caso: El objetivo es presentar un protocolo de desensibilizaci\u00f3n personalizado en paciente femenino de 36 a\u00f1os, con Lupus eritematoso sist\u00e9mico (LES) tratada previamente con rituximab en 2019, 4 dosis, presentando durante cuarta administraci\u00f3n, a los 10 minutos, disnea, sensaci\u00f3n de cuerpo extra\u00f1o en faringe, dolor tor\u00e1cico, angioedema y alteraci\u00f3n neurol\u00f3gica. Requiriendo nueva administraci\u00f3n de rituximab por proteinuria persistente secundario a LES. Previa realizaci\u00f3n de pruebas cut\u00e1neas (negativas), se realiza esquema de desensibilizaci\u00f3n de 13 pasos con 3 concentraciones (soluci\u00f3n: A [1:100], B [1:10] y C [1:1]). Ya que s\u00f3lo 52% de RHS a rituximab resultan positivas en pruebas cut\u00e1neas y ante grado de reacci\u00f3n (grave), se decide desensibilizaci\u00f3n, basado en reacciones presentadas por paciente y contexto cl\u00ednico. Logrando llegar a dosis acumulada de 897.87 mg en un periodo de 5 horas, sin reacciones durante ni posterior a procedimiento, concluy\u00e9ndose exitosamente.\nConclusi\u00f3n: Mediante realizaci\u00f3n de protocolos de desensibilizaci\u00f3n se permite administraci\u00f3n de un medicamento, ofreciendo una opci\u00f3n terap\u00e9utica segura, cuando \u00e9ste es tratamiento de elecci\u00f3n en pacientes sensibilizados previamente, ofreciendo una alternativa cuando los beneficios superan los riesgos de su administraci\u00f3n.<\/jats:p>","DOI":"10.29262\/ram.v70i3.1288","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T08:01:39Z","timestamp":1694505699000},"page":"197","source":"Crossref","is-referenced-by-count":0,"title":["Desensibilizaci\u00f3n a Rituximab en paciente con proteinuria persistente secundaria a LES"],"prefix":"10.29262","volume":"70","author":[{"given":"Nayeli","family":"Serv\u00edn Suarez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"M\u00e9ndez G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla","family":"Korkowski-Uvi\u00f1a","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hector","family":"Carrillo Murillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Torres Rojo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margarita","family":"Ortega Cisneros","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itzel Vianey","family":"Ochoa Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"11808","published-online":{"date-parts":[[2023,8,21]]},"reference":[{"key":"55521","doi-asserted-by":"crossref","unstructured":"* Fouda GE, Bavbek S. Rituximab Hypersensitivity: From Clinical Presentation to Management. Front Pharmacol. 2020;11:572863. Published 2020 Sep 8. doi:10.3389\/fphar.2020.572863","DOI":"10.3389\/fphar.2020.572863"},{"key":"55522","doi-asserted-by":"crossref","unstructured":"*Zurita Gavilanes L, Costa Valarezo A. Rituximab en nefritis lu\u0301pica: una revisio\u0301n no sistema\u0301tica. Reumatol Cli\u0301nica. 2016;12(4):210-5. doi.org\/10.1016\/j.reuma.2016.01.001","DOI":"10.1016\/j.reuma.2016.01.001"},{"key":"55523","unstructured":"* Esparza-Carrillo D, Rodri\u0301guez-Gonza\u0301lez M, Azamar-Ja\u0301come A, Venegas-Montoya E, Falck- Fuentes C, Lo\u0301pez-Herna\u0301ndez G, et al. Desensibilizacio\u0301n a rituximab: reporte de un paciente pedia\u0301trico en protocolo de trasplante de ce\u0301lulas hematopoye\u0301ticas. 2016;25."},{"key":"55524","doi-asserted-by":"crossref","unstructured":"* O\u0308ztu\u0308rk E, O\u0308zyig\u0306it LP, O\u0308ztu\u0308rk AB, Akay MO, C\u0327etiner M, Ferhanog\u0306lu B. Rituximab desensitization in three patients with severe rituximab allergy. Curr Probl Cancer. 2017;41(5):349-354. doi:10.1016\/j.currproblcancer.2017.07.003","DOI":"10.1016\/j.currproblcancer.2017.07.003"},{"key":"55525","doi-asserted-by":"crossref","unstructured":"*Cardona R, Santamari\u0301a L, Guevara-Saldan\u0303a LM, Calle A. Hipersensibilidad a antibio\u0301ticos betalacta\u0301micos: algoritmos de manejo y desensibilizacio\u0301n como alternativa terape\u0301utica vital. Rev Alerg Me\u0301xico. 7 de junio de 2021;68(1):35-47.","DOI":"10.29262\/ram.v68i1.892"}],"container-title":["Revista Alergia M\u00e9xico"],"original-title":[],"link":[{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1288\/2079","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1288\/2079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T08:01:45Z","timestamp":1694505705000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.revistaalergia.mx\/ojs\/index.php\/ram\/article\/view\/1288"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,21]]},"references-count":5,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,9,11]]}},"URL":"https:\/\/doi.org\/10.29262\/ram.v70i3.1288","relation":{},"ISSN":["2448-9190","0002-5151"],"issn-type":[{"value":"2448-9190","type":"electronic"},{"value":"0002-5151","type":"print"}],"subject":[],"published":{"date-parts":[[2023,8,21]]}}}