Clinical Case of Drug Allergy to Enzyme Replacement Therapy in a Patient with Mucopolysaccharidosis Type II
Bibliographic record
Abstract
Background. Enzyme replacement therapy (ERT) with iduronate-2-sulfatase recombinant forms (idursulfase and idursulfase beta) is effective for the management of mucopolysaccharidosis type II (MPS II). Patients with Hunter syndrome require lifelong ERT that can negate endogenous enzyme deficiency. However, hypersensitivity reactions may occur during ERT, and they significantly complicate the implementation of vital therapy. Clinical case description. This article describes clinical case of a child with hypersensitivity reaction to ERT. The patient with confirmed diagnosis of MPS II was administrated with idursulfase. Then, the drug was replaced with idursulfase beta due to the allergic reaction. Thus, even after the drug change, side effects maintained without sustained improvement with underlying glucocorticosteroids (GCS), antihistamines and with decreased infusion rate. Concerning the vital need to continue ERT, this patient with drug allergy to this pharmacotherapeutic group was further administered with combined therapy of cyclosporine and omalizumab. Personalised protocol for the administration of idursulfase beta with desensitization was developed. Such experience was firstly described In Russian patient. Conclusion. The presented personalised combination therapy made it possible to prevent hypersensitivity reactions during ERT in the patient with MPS II.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".