Dessensibilização com albumina humana em paciente
com cirrose hepática: relato de caso

Maria Eduarda Trocoli Zanetti; Natalia Dias Melo; Gabriel Veloso Araujo-Neto; Ana Leticia Romanini; Lais Matuda1; Maria Tereza Stein; Mariana Paes Leme Ferriani; José Eduardo Lemos; Guilherme Massote Fontanini; Marcia Guimarães Villanova; Luisa Karla Arruda; Ullissis Pádua Menezes

doi:10.4322/2526-5393.20250045

Comunicação Clínica e Experimental

Dessensibilização com albumina humana em paciente com cirrose hepática: relato de caso

Desensitization to human albumin in a patient with hepatic cirrhosis: a case report

Maria Eduarda Trocoli Zanetti, Natalia Dias Melo, Gabriel Veloso Araujo-Neto, Ana Leticia Romanini, Lais Matuda1, Maria Tereza Stein, Mariana Paes Leme Ferriani, José Eduardo Lemos, Guilherme Massote Fontanini, Marcia Guimarães Villanova, Luisa Karla Arruda, Ullissis Pádua Menezes

http://dx.doi.org/10.4322/2526-5393.20250045 Arq Asma Alerg Imunol, vol.9, n4, p.458-462, 2025

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Resumo

A cirrose hepática pode apresentar complicações graves como ascite e síndrome hepatorrenal (SHR), cujo manejo exige a infusão de albumina humana como terapia essencial. Reações de hipersensibilidade à albumina, embora raras, podem ser graves e representarem um desafio no manejo destes pacientes. Relatamos o caso de um homem de 55 anos, com cirrose hepá‑ tica de etiologia alcoólica, que desenvolveu anafilaxia durante a reposição de albumina pós-paracentese de grande volume. Na investigação diagnóstica, o teste cutâneo intradérmico de hiper‑ sensibilidade imediata à albumina foi positivo. A dessensibilização rápida com protocolo em 8 etapas foi realizada com sucesso, e permitiu a reexposição do paciente à dose plena de albumina sem reações adversas. A dessensibilização pode ser utilizada como um procedimento seguro no manejo da hipersensibilidade à albumina em pacientes com cirrose descompensada.

Palavras-chave

Hipersensibilidade a drogas, hipersensibilidade imediata, cirrose hepática, albumina sérica humana, dessensibilização imunológica.

Abstract

Liver cirrhosis may lead to severe complications such as ascites and hepatorenal syndrome (HRS), requiring human albumin infusion as an essential therapy. Hypersensitivity reactions to albumin, although rare, may be severe and pose a challenge in the management of these patients. We report the case of a 55-year-old man with alcoholic liver cirrhosis who developed anaphylaxis during albumin replacement following large-volume paracentesis. During the diagnostic workup, an intradermal skin test for immediate hypersensitivity to albumin yielded a positive result. A rapid 8-step desensitization protocol was successfully performed, allowing the patient to be re-exposed to the full albumin dose without adverse reactions. Desensitization may represent a safe procedure for managing albumin hypersensitivity in patients with decompensated cirrhosis.

Keywords

Drug hypersensitivity, immediate hypersensitivity, liver cirrhosis, human serum albumin, immunologic desensitization.

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Submetido em:
10/11/2025

Aceito em:
29/01/2026