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ORIGINAL RESEARCH article
Front. Allergy
Sec. Drug, Venom & Anaphylaxis
Volume 5 - 2024 |
doi: 10.3389/falgy.2024.1361403
Drug Fever – An immune mediated delayed type hypersensitivity reaction to Vinca alkaloids in pediatric oncology patients, possibly mediated by cysteinyl leukotrienes
Provisionally accepted- 1 Edmond and Lily Safra Children's Hospital, Ramat Gan, Israel
- 2 Sackler Faculty of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Tel Aviv, Israel
- 3 Sheba Medical Center, Ramat Gan, Tel Aviv District, Israel
Drug hypersensitivity reactions are relatively frequent in pediatric hemato-oncology patients, because of multi-pharmacology, immune compromise, concomitant infections and intrinsic drug mechanisms of action. High fever, can be a manifestation of severe delayed type hypersensitivity reactions such as Drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome (DIHS/DRESS), but the pathogenesis of fever as an isolated hypersensitivity reaction to chemotherapeutic agents is unclear. We present a series of children with diverse intracranial neoplasms, developing a recurrent delayed febrile reaction after repeated courses of a Vinca Alkaloid based chemotherapy. Pre/post treatment with a cysteinyl leukotriene receptor antagonist completely abrogated the occurrence of fever, enabling the completion of the required course of chemotherapy. Additional research is required as to the mechanism of drug fever and the potential leukotriene pathways involved.
Keywords: Fever, adverse drug reactions, chemotherapy, Leukotrienes, oncology
Received: 25 Dec 2023; Accepted: 12 Jul 2024.
Copyright: © 2024 Kidon, Haj Yahia, Abebe-Campino, Agmon-Levin and Yelon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Mona I. Kidon, Edmond and Lily Safra Children's Hospital, Ramat Gan, Israel
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Soad Haj Yahia
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