Dessensibilização rápida ao tocilizumabe em lactentes: relato de casos
Rapid desensitization to tocilizumab in infants: case reports
Maria Eduarda Trocoli Zanetti, Gabriel Veloso de Araujo-Neto, Isabela Gazola Dusso, Lais Fukuda Cuoghi, Ana Claudia Rossini Clementino, Laura Cardoso Brentini, Stephanie Zago Geraldino, Matheus Henrique Botaro, Natalia Maronese, Anne Marielle Camargo, José Eduardo Seneda Lemos, Mariana Paes Leme Ferriani, Francisco Hugo Rodrigues Gomes, Pérsio Roxo-Junior, Luisa Karla Arruda, Ullissis Pádua Menezes
Resumo
O tocilizumabe consiste em uma opção terapêutica no manejo de condições pediátricas graves, como a Artrite Idiopática Juvenil Sistêmica e Linfo-histiocitose hemofagocítica. No entanto, reações de hipersensibilidade imediata podem ocorrer durante o tratamento. A Dessensibilização Rápida a Medicamentos torna-se uma opção terapêutica em pacientes com reações de hipersensibilidade ao tocilizumabe. Relatamos a experiência de dessensibilização rápida a medicamentos em dois lactentes que apresentaram reações de hipersensibilidade imediata ao tocilizumabe, incluindo um episódio de anafilaxia. Foram utilizados protocolos de indução de tolerância adaptados para baixo peso e restrição de volume. Ambos os pacientes toleraram a reintrodução de 100% da dose alvo, sem reações graves, permitindo a manutenção regular da terapia. Estes relatos sugerem que a dessensibilização ao tocilizumabe é uma estratégia viável, segura e eficaz mesmo em lactentes.
Palavras-chave
Abstract
Tocilizumab is a therapeutic option for managing severe pediatric conditions, such as Systemic Juvenile Idiopathic Arthritis and hemophagocytic lymphohistiocytosis. However, immediate hypersensitivity reactions can occur during treatment. Rapid drug desensitization serves as a therapeutic option for patients experiencing hypersensitivity reactions to tocilizumab. We report the experience of rapid drug desensitization in two infants who exhibited immediate hypersensitivity reactions to tocilizumab, including one episode of anaphylaxis. Tolerance induction protocols adapted for low body weight and volume restrictions were used. Both patients tolerated the reintroduction of the full target dose without severe reactions, allowing for the continuation of regular therapy. These reports suggest that tocilizumab desensitization is a feasible, safe, and effective strategy, even in infants.
Keywords
Referências
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Submetido em:
17/03/2026
Aceito em:
07/07/2026
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