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Hypersensitivity reactions to intravenous iron: guidance for risk minimization and management.

Rampton, David and Folkersen, Joergen and Fishbane, Steven and Hedenus, Michael and Howaldt, Stefanie and Locatelli, Francesco and Patni, Shalini and Szebeni, Janos and Weiss, Guenter (2014) Hypersensitivity reactions to intravenous iron: guidance for risk minimization and management. Haematologica, 99 (11). pp. 1671-6. ISSN 1592-8721. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs

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Official URL: http://www.haematologica.org/content/99/11/1671.lo...

Abstract

Intravenous iron is widely used for the treatment of iron deficiency anemia when oral iron is inappropriate, ineffective or poorly tolerated. Acute hypersensitivity reactions during iron infusions are very rare but can be life-threatening. This paper reviews their frequency, pathogenesis and risk factors, and provides recommendations about their management and prevention. Complement activation-related pseudo-allergy triggered by iron nanoparticles is probably a more frequent pathogenetic mechanism in acute reactions to current formulations of intravenous iron than is an immunological IgE-mediated response. Major risk factors for hypersensitivity reactions include a previous reaction to an iron infusion, a fast iron infusion rate, multiple drug allergies, severe atopy, and possibly systemic inflammatory diseases. Early pregnancy is a contraindication to iron infusions, while old age and serious co-morbidity may worsen the impact of acute reactions if they occur. Management of iron infusions requires meticulous observation, and, in the event of an adverse reaction, prompt recognition and severity-related interventions by well-trained medical and nursing staff.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs
Subjects: WQ Obstetrics. Midwifery
Divisions: Womens and Childrens > Obstetrics
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Depositing User: Mrs Caroline Tranter
Date Deposited: 06 Jul 2015 13:09
Last Modified: 06 Jul 2015 13:09
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1009

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