While drug reactions to rituximab have been commonly reported in the literature, a type I allergic reaction to rituximab after first lifetime exposure has never been reported. We describe a case of a 58-year-old female patient who received rituximab for the first time for treatment of rheumatoid arthritis. She developed symptoms immediately after infusion, however presented 11 days after drug exposure with cyclical anaphylaxis-like reaction requiring multiple doses of epinephrine. On second exposure, she experienced immediate anaphylaxis 30 min into infusion. Our case illustrates the importance of heightened awareness by physicians that type I IgE-mediated reactions after first exposure to monoclonal antibodies such as rituximab are possible, and if unrecognized, could be potentially life-threatening.

中文翻译：

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第一次终生暴露时对利妥昔单抗的 I 型过敏反应：病例报告。

虽然文献中普遍报道了对利妥昔单抗的药物反应，但从未报道过在首次终生暴露后对利妥昔单抗的 I 型过敏反应。我们描述了一名 58 岁女性患者首次接受利妥昔单抗治疗类风湿性关节炎的病例。她在输注后立即出现症状，但在药物暴露 11 天后出现需要多剂量肾上腺素的周期性过敏反应样反应。在第二次暴露时，她在输注 30 分钟后立即出现过敏反应。我们的案例说明了医生提高认识的重要性，即第一次接触利妥昔单抗等单克隆抗体后可能发生 I 型 IgE 介导的反应，如果未被识别，可能会危及生命。