Factor VIII


Recombinant factor VIII products are used in the treatment of hemophilia.
 
Incidence
0.1 to 0.75% (rashes).
 
Clinical manifestations
General: anaphylactic shock.
 
Cutaneous: erythematous or urticarial rashes.
 
Diagnostic methods
Specific IgE (Intermediate purity factor VIII concentrates).
 
Mechanisms
IgG 4 antibodies to bovine factor VIII?
 
IgE-mediated hypersensitivity?
 
Antibodies against human serum albumin?
 
Ethyleneoxide allergy?
 
Management
Premedication with antihistamines and corticosteroids.
 
Desensitization.

References

  1. Shopnick R.I, Kazemi M, Brettler D.B, Buckwalter C, Yang L, Bray G, Gomperts E.D, "Anaphylaxis after treatment with recombinant factor VIII", Transfusion., 1996; 36: 358-61
  2. Bove J.R, "Anaphylactic reaction to purified anti-hemophilic factor concentrate (letter)", Transfusion, 1988; 28: 603
  3. Jamieson D.M, Stafford C.T, Maloney M.J, Lutcher C.L, "Desensitization to factor VIII in a patient with classic hemophilia and C2 deficiency", Ann. Allergy., 1987; 58: 215-20
  4. Shakib F, Stanworth D.R, "IgG 4: a possible mediator of anaphylaxis in a haemophiliac patient", Clin. Allergy., 1979; 9: 597-603

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.