福沙匹坦双葡甲胺致过敏反应

Anaphylaxis due to fosaprepitant dimeglumine

1例16岁女性急性T淋巴细胞白血病患者准备行异基因造血干细胞移植术,术前需要进行预处理化疗,为减轻化疗不良反应程度,给予昂丹司琼+地塞米松+福沙匹坦双葡甲胺三联药物。静脉注射昂丹司琼4 mg和地塞米松5 mg后,将福沙匹坦双葡甲胺150 mg入0.9%氯化钠注射液150 ml,以300 ml/h速度持续静脉泵入。5 min后,患者出现大汗,咽部异物感,呼吸困难,脐周疼痛和呕吐。考虑可能为福沙匹坦双葡甲胺所致过敏反应,立即停用该药,给予地塞米松5 mg静脉注射和吸氧。20 min后患者呼吸困难好转,腹痛减轻;50 min后过敏症状消失。

A 16⁃year⁃old female patient with acute T⁃cell leukemia was going to undergo allogeneic hematopoietic stem cell transplantation.Pretreatment chemotherapy was required before operation.In order to reduce the degree of adverse reactions during the chemotherapy,the patient received treatments with ondansetron,dexamethasone,and fosaprepitant dimeglumine.After intravenous injections of ondansetron 4 mg and dexamethasone 5 mg,fosaprepitant dimeglumine 150 mg dissolved in 0.9%sodium chloride injection 150 ml was intravenously pumped at a speed of 300 ml/h.Five minutes later,the patient developed sweating,foreign body sensation in pharynx,dyspnea,periumbilical pain,and vomiting.Anaphylactic reac⁃tion caused by fosaprepitant dimeglumine was considered.The drug was stopped immediately and intrave⁃nous injection of dexamethasone 5 mg and oxygen inhalation were given.Twenty minutes later,her symptoms of dyspnea and abdominal pain were relieved.Fifty minutes later,the allergic symptoms disappeared.