Case Report

Desensitization to Hydroxychloroquine — Experience of 4 Patients

MICHAL MATES, SHOSHANA ZEVIN, GABRIEL S. BREUER, PNINA NAVON, and GIDEON NESHER

ABSTRACT.

Hydroxychloroquine (HCQ) is an antimalarial agent with immunomodulatory effects. It is widely used in rheumatologic diseases, and has a very high efficacy/toxicity ratio. It is particularly important in the treatment of systemic lupus erythematosus (SLE) since it reduces new organ involvement and disease flares, and relieves skin and joint symptoms. Some patients develop hypersensitivity rash in response to HCQ. In such patients the drug is withdrawn and replaced by another medication. All the alternative medications for rheumatological patients are significantly more toxic than HCQ. We describe our initial experience of HCQ slow oral desensitization. All 4 patients who were recruited completed the procedure successfully without significant difficulty. Our results suggest that HCQ slow oral desensitization is safe, effective, and easy to perform. (First Release Feb 1, 2006; J Rheumatol 2006;33:814–6)

Key Indexing Terms:

HYDROXYCHLOROQUINE
HYPERSENSITIVITY
DESENSITIZATION

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From the Department of Internal Medicine and Rheumatology Clinic, Department of Pediatrics and Pediatric Rheumatology Clinic, Shaare Zedek Medical Center, Jerusalem, Israel.

M. Mates, MD, Lecturer, Department of Internal Medicine and Rheumatology Clinic; S. Zevin, MD, Senior Lecturer, Department of Internal Medicine; G.S. Breuer, MD, Lecturer, Department of Internal Medicine and Rheumatology Clinic; P. Navon, MD, Department of Pediatrics and Pediatric Rheumatology Clinic; G. Nesher, MD, Clinical Associate Professor, Department of Internal Medicine and Rheumatology Clinic.

Address reprint requests to Dr. M. Mates, Department of Internal Medicine, Shaare Zedek Medical Center, POB 3235, Jerusalem, 91031, Israel. E-mail: rheum@szmc.org.il

Accepted for publication November 30, 2005.

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