@article{article_1712338, title={A Patient with Local Hypersensitivity Reactions to Three TNF-α Inhibitors and Local/Systemic Hypersensitivity Reactions to Tocilizumab: Desensitization to Tocilizumab}, journal={Ankara Üniversitesi Tıp Fakültesi Mecmuası}, volume={75}, pages={130–133}, year={2022}, DOI={10.4274/atfm.galenos.2021.92005}, author={Bavbek, Sevim}, keywords={TNF-α Inhibitors, Tocilizumab, Local Hypersensitivity Reactions, Anaphylaxis, Desensitization}, abstract={Tumor necrosis factor-alpha (TNF-α) inhibitors are effective alternatives for chronic inflammatory diseases. They are generally well tolerated; however, they may lead to the immediate/delayed local or systemic hypersensitivity reactions (HSR). Tocilizumab is a monoclonal antibody against interleukin 6 receptors. It is given both via intravenous (IV) and subcutaneous (SC) routes and there are limited data reporting that the overall injection and/or infusion reaction rate to tocilizumab is estimated as 7-8%. Cross-reactivity between either TNF-α inhibitors or tocilizumab is not expected. However, we herein present an unusual case of a patient who reacted with local injection site reactions (ISRs) to three TNF-α inhibitors, adalimumab, etanercept, and golimumab. The patient then reacted with ISR and anaphylaxis to SC and IV tocilizumab, respectively. Skin prick tests with all biologicals were negative but positive in early readings of intradermal testing. After all, tocilizumab was successfully administered via rapid drug desensitization.}, number={1}, publisher={Ankara University}