Successful treatment of neurocysticercosis with albendazole desensitization
Anh P. Nguyen,1 Wesley Hoffman,4 Bennett H. Penn,5 David Pham,6 Suzanne S. Teuber2,3
1 Department of Pediatrics; Division of Allergy, Immunology and Rheumatology, University of California Davis, School of Medicine, Sacramento, CA, USA.
2 Department of Internal Medicine; Division of Rheumatology, Allergy and Clinical Immunology, University of California Davis, School of Medicine, Sacramento, CA, USA.
3 Veterans Affairs Northern California Healthcare System, Mather, CA, USA.
4 University of Louisville Health – Jewish Hospital, Pharmacy, Louisville, KY, USA
5 Department of Internal Medicine; Division of Infectious Diseases, University of California Davis, School of Medicine, Sacramento, CA, USA
6 Department of Radiology, University of California Davis, School of Medicine, Sacramento, CA, USA
Abstract
Background: Neurocysticercosis is a growing public health problem in the United States. Albendazole is a mainstay of medical therapy for neurocysticercosis, and here we present a case of hypersensitivity to albendazole leading to life-threatening disease progression.
Objective: To report the first successful albendazole desensitization protocol.
Methods: An oral albendazole 12-step desensitization protocol was developed, starting with 0.001 mg and progressing at 15 minutes intervals. Dosage for each subsequent step was as follows: 0.003 mg, 0.01 mg, 0.03 mg, 0.1 mg, 0.3 mg,
1 mg, 3 mg, 10 mg, 30 mg, 100 mg, 300 mg.
Results: The patient rapidly improved from a symptomatic standpoint, and repeat MRI showed a dramatic improvement in lesions.
Conclusion: This successful desensitization protocol to albendazole can be of value to other patients with history suggestive of IgE-mediated allergy needing treatment for parasitic infections.
Key words: Albendazole, Adverse drug reaction, Anti-parasite, Drug hypersensitivity, Desensitization, Orally, Neurocysticercosis