Hypersensitive reaction due to ferric carboxymaltose in a post-partum mother experienced in a tertiary care hospital in West Bengal, India: A case report

Abstract

Iron deficiency anaemia (IDA) is highly associated with insufficient nutrition, chronic renal failure and congestive heart failure. Post-partum anaemia is also very common with a high mortality rate. Ferric carboxymaltose (FCM) is a non-dextran third-generation intravenous (IV)-iron preparation. FCM is an effective means of correcting IDA and improving haemoglobin (Hb) concentration in IDA. Incidence of IDA is common in low socio-economic groups. Clinical research has shown that the risk of hypersensitivity reaction (HSR) with FCM is low. An 18- year-old female has faced post-partum anaemia. IDA is most common due to low socio-economic status. Day 1 of post-partam period, Hb was 6.5 g/dl. One unit of packed red blood cell has been transfused. The next day, the Hb was 7.1, so, IV FCM was advised. The patient had faced a serious HSR. Sudden respiratory distress occurred and chest congestion was present. SpO 2 had dropped to 85%. The case was primarily managed with Injection (Inj) Adrenaline, Inj Hydrocortisone, Inj Promethazine, oxygen and nebulization. In this case report, we are reporting a case of severe HSR due to administration of IV FCM in a post-partum mother. It should be kept in mind that severe HSR can be seen due to IV FCM infusion. During the infusion, proper monitoring is important. FCM should be advised in a well-equipped setup where proper infrastructure and protocols are present to combat the HSR.