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Discussion Starter · #1 ·
I am cross posting this from Special Needs- hopefully someone here will also have some insight!

DS was hospitalized last week for an IV iron infusion. He had an anaphylactoid reaction in the 3rd hour of his infusion- he went from fine to nearly needing intubation within 62 seconds. I have actually seen patients die from anaphylaxis, so I kind of lost my mind. We know it was anaphylactoid, not anaphlyactic, because his IgE didn't increase (although he did have some major shifts in his white cell percentages).

He is about to be admitted again for some additional infusions, and we are trying to determine whether he had a toxic reaction to the iron, or an allergic reaction to the sugar source. So far, nobody can tell us (outside of skin prick testing, which we can't do this soon after a reaction) what tests to run. The sugar in the IV solution will most likely be in the other meds he gets this next go-round, and we need to figure out what/how to monitor. It's doubly perplexing because his reaction happened so late.

If anyone else has been through this type of thing, what was monitored in subsequent infusions? We can certainly premedicate him with benadryl and steroids, but we'd love to know if there is a way we can avoid putting him through this again.

Thanks!
 

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I'm anemic. I've been told that anaphylaxis is simply a risk of IV iron infusions, the reason isn't well understood. I always premedicate before receiving an infusion and the nurses always double-check that I've done so.

While I've had anaphylactic reactions to other things, I've never had one to iron sucrose, so I don't know what would happen if I did react--what my hematologist would choose to do for further iron supplementation.
 

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I have no idea what the answer to your question is but you and your LO DON'T NEED ANYTHING ELSE ON YOUR PLATE for goodness sake. This just makes me want to scream for you. I am so very sorry you had this incredibly scary episode. Big big hugs.
 

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Discussion Starter · #5 ·
thanks all!

yes, it was sucrose- our gastro said the chance of such a severe reaction with iron sucrose is 0.6 per 1 million.
They actually had some concern at first it was an accidental overdose due to pharmacy error, since the reaction showed up late, but more or less ruled it out based on his serum iron levels and rechecking what he'd been given.

If it was an overload/toxic reaction, what I'm hoping is that we could (when he needs it again) do much smaller quantities. I have resigned myself to needing long-term IV access for him. This kind of solidified my stance on it.
 
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