Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Paclitaxel (Taxol) a taxane antineoplastic agent causing irreversible microtubule aggregation with activity against breast, ovarian, lung, head and neck, bladder, testicular, esophageal, endometrial and other less common tumors was derived from the bark of the Pacific yew (Taxus brevifolia). Phase I trials conducted in the late 1980s were almost halted because of the high frequency of hypersensitivity-like reactions. Respiratory distress (dyspnea and/or bronchospasm), hypotension, and angioedema were the major manifestations, but flushing, urticaria, chest, abdomen, and extremity pains were described also. Reactions occurred on first exposure in the majority of cases raising etiologic questions. The vehicle for paclitaxel Cremophor EL (polyoxyethylated castor oil in 50% ethanol) was strongly suspect as a direct (non-immunoglobulin E dependent) histamine releaser. Premedication regimens and longer infusion times lowered the incidence of reactivity allowing phase II and III trials to progress through the early 1990s. The mechanism(s) underlying paclitaxel hypersensitivity-like reactions is still unknown, and clinical data on probable complement and mast cell activation are lacking. The original clinical trial protocols for paclitaxel required discontinuation of therapy for patients who experienced hypersensitivity-like reactions. Here, we review the current etiologic knowledge of these reactions and describe our clinical approach to allow completion of chemotherapy with this powerful plant-derived agent.
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PMID:Taxol reactions. 1212 9

A 73-year-old Caucasian woman with metastatic bladder cancer developed hives, itching, difficulty in breathing, and general ill-feeling during the first 10 min of her first infusion of paclitaxel. Paclitaxel was discontinued and the symptoms resolved after intravenous diphenhydramine and hydrocortisone treatment. Upon discussion with the patient, she described the sensation as similar to her reaction to hazelnuts. The patient's only other allergy was to azithromycin, which presented as hives. A PubMed literature search revealed that paclitaxel is found in the components of the hazelnut tree and its nuts. While a nut-protein allergy cannot be ruled out, a cross-reaction between paclitaxel and hazelnuts is a possibility. Patients who describe an allergy to hazelnuts must be carefully observed while being treated with paclitaxel. The hazelnut allergy may not be a nut-protein allergy at all, but rather an allergy to the components of paclitaxel that reside in the hazelnut itself.
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PMID:Cross-reactivity between paclitaxel and hazelnut: a case report. 1762 69

Paclitaxel (Taxol) is an intravenously administered antineoplastic agent derived from the yew tree, Taxus brevifolia, whose mechanism of action involves inhibition of mitosis. Some of the mucocutaneous reactions to the drug that have been observed include alopecia, mucositis, hypersensitivity reactions (with erythema and urticaria), nail changes, changes occurring at intravenous sites, and radiation recall dermatitis. Less commonly, acral erythema, erythema multiforme, pustular dermatitis, and scleroderma-like changes have been described. A female patient who was receiving adjuvant weekly paclitaxel for the treatment of intraductal breast carcinoma developed photodistributed erythema multiforme and onycholysis after sun exposure to the affected areas. Including this woman, paclitaxel-associated photosensitve conditions have only been reported in 9 female oncology patients: onycholysis (5), erythema multiforme and onycholysis (2), photo-recall phenomenon (1), and subacute cutaneous lupus erythematosus (1). The patients were either receiving treatment for breast carcinoma (8) or lung cancer (1). The skin lesions developed on sun-exposed areas, usually after the patient had received several weekly doses of paclitaxel, and resolved following discontinuation of the drug. Several of the patients were subsequently able to receive additional cycles of paclitaxel without recurrence of their drug-associated photosensitive conditions by concurrently using photoprotection to prevent additional sun exposure to the previously affected sites during treatment.
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PMID:Photodistributed erythema multiforme: paclitaxel-related, photosensitive conditions in patients with cancer. 1918 Aug 97

Paclitaxel and docetaxel are antineoplastic drugs derived from the yew tree, Taxus brevifolia. They are the members of the taxane family and act by inhibiting mitotic activity due to the suppression of microtubule depolymerization. They are used in the treatment of ovarian cancer, breast cancer, gastric cancer, small cell lung cancer, and head and neck cancer. In addition to side effects such as cardiotoxicity, neutropenia, arthralgia, and myalgia, they may also cause alopecia, urticaria, mucositis, acral erythema, pustular dermatitis, erythema multiforme, and scleroderma-like mucocutaneous lesions. Scleroderma is among the uncommon side effects of taxane antineoplastic agents. As was the case in few cases in literature, it usually begins with edematous changes in the proximal aspect of the extremities, and subsequently, sclerosis is developed in the skin. Scleroderma, which usually regresses with the discontinuation of the drug and with steroid therapy, may lead to severe contractions that require physical therapy and rehabilitation in some patients. In this paper, we presented a 60-year-old female patient in whom scleroderma developed because docetaxel chemotherapy for breast cancer because it is encountered rarely.
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PMID:Docetaxel-induced Scleroderma in A Breast Cancer Patient: A Case Report. 2833