Hypersensitivity to Rituximab in Children

Pharmacology. 2021;106(5-6):341-344. doi: 10.1159/000511458. Epub 2020 Nov 17.


Biological agents have had an increased usage during the past years, also in pediatric population. Monoclonal antibodies can cause adverse drug reactions with different pathomechanisms, including type I IgE-mediated hypersensitivity reactions (HR). In this report, we describe 2 children who had a diagnosis of anaphylaxis to rituximab (RTX), confirmed by positive in vivo tests in both cases and elevated tryptase value in one case. We also made a review of the few cases of HR to RTX in pediatric population reported in literature and discuss differential diagnosis and utility of allergy investigations.

Keywords: Allergy workup; Children; Hypersensitivity reaction; Pediatrics; Rituximab.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anaphylaxis / chemically induced
  • Anaphylaxis / diagnosis
  • Child, Preschool
  • Diagnosis, Differential
  • Drug Hypersensitivity / diagnosis*
  • Drug Hypersensitivity / etiology
  • Female
  • Humans
  • Immunologic Factors / adverse effects*
  • Immunologic Factors / therapeutic use
  • Infusions, Intravenous
  • Male
  • Review Literature as Topic
  • Rituximab / administration & dosage
  • Rituximab / adverse effects*
  • Tryptases / metabolism


  • Immunologic Factors
  • Rituximab
  • Tryptases