1例利妥昔单抗致肾病综合征儿童过敏性休克的病例分析

A case study of rituximab-induced anaphylactic shock in a child with nephrotic syndrome

目的:探讨利妥昔单抗(RTX)致儿童过敏性休克的高危因素及预防措施,为儿童安全使用RTX提供参考。方法:回顾性分析1例RTX致儿童过敏性休克的病例,通过查阅文献,对过敏性休克可能的发生机制、高危因素及预防措施进行分析。结果:RTX的初始使用年龄、输注速率是发生不良事件的危险因素,在使用RTX前应预先给予激素、解热镇痛药或抗组胺药等预防输液反应,使用中应注意滴注速度,使用后对患者进行密切监护,尤其是使用后的30~120min。结论:RTX是一种人鼠嵌合型单克隆抗体,不良事件发生率高,使用时临床药师要对其进行全程药学监护。

Objective:To explore the high-risk factors and preventive measures of rituximab(RTX)-induced anaphylactic shock in children,and to provide reference for the safe use of RTX in children.Methods:A case of RTX-induced anaphylactic shock in a child was retrospectively analyzed,and its possible mechanisms,high-risk factors and preventive measures were analyzed by reviewing the literature.Results:The age of initial use and infusion rate of RTX were the risk factors for the occurrence of adverse events.Hormones,antipyretic analgesics or antihistamines should be given in advance to prevent infusion reactions before use of RTX,attention should be paid to the rate of titration during use of RTX,and the patient should be closely monitored after use of RTX,especially 30-120 min after use.Conclusion:RTX is a human-mouse chimeric monoclonal antibody with a high incidence of adverse events,and the clinical pharmacist should carry out full pharmacological monitoring when it is used.