Infusion reaction
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: acute infusion reaction; infusion-related reaction
Overview
Infusion reactions is defined as a reaction to the infusion of pharmacological or biological substances. Symptoms may appear within minutes to hours following the infusion and may include pruritus, flushing, swelling, dyspnea, bronchospasm, and hypotension.[1]
Classification
Common Terminology Criteria for Adverse Events (CTCAE) Grade
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CTCAE Grade 1 Cytokine Release Syndrome or Acute Infusion ReactionMild reaction; infusion interruption not indicated; intervention not indicated. CTCAE Grade 2 Cytokine Release Syndrome or Acute Infusion ReactionRequires therapy or infusion interruption but responds promptly to symptomatic treatment (e.g., antihistamines, NSAIDS, narcotics, IV fluids); prophylactic medications indicated for ≤24 hrs. CTCAE Grade 3 Cytokine Release Syndrome or Acute Infusion ReactionProlonged (i.e., not rapidly responsive to symptomatic medication and/or brief interruption of infusion); recurrence of symptoms following initial improvement; hospitalization indicated for other clinical sequelae (e.g., renal impairment, pulmonary infiltrates). CTCAE Grade 4 Cytokine Release Syndrome or Acute Infusion ReactionLife-threatening; pressor or ventilatory support indicated. CTCAE Grade 5 Cytokine Release Syndrome or Acute Infusion ReactionDeath. |
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Causes
Common Causes
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect |
Denileukin diftitox, galsulfase, Ibritumomab tiuxetan, laronidase, Pegloticase |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional / Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal / Electrolyte | No underlying causes |
| Rheum / Immune / Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Dental | No underlying causes |
| Miscellaneous | No underlying causes |
Causes in Alphabetical Order
Diagnosis
Signs and Symptoms
- Flushing
- Itching
- Alterations in heart rate and blood pressure
- Dyspnea or chest discomfort
- Back or abdominal pain
- Fever and/or shaking chills
- Nausea, vomiting, and/or diarrhea
- Various types of skin rashes
- Throat tightening
- Hypoxia
- Seizures
- Dizziness and/or syncope
- Signs and symptoms of anaphylaxis
References
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