August 5, 2019

Canadian expert consensus: management of hypersensitivity reactions to intravenous iron in adults

Wendy Lim    Waqqas Afif    Sandra Knowles    Gloria Lim    Yulia Lin    Charmaine Mothersill    Irina Nistor  Faisal Rehman    Christine Song    Ted Xenodemetropoulos

Original Paper  Open Access

Abstract
Background and Objectives

Rare but potentially life‐threatening hypersensitivity reactions can occur during the administration of intravenous iron. To provide guidance to healthcare professionals caring for adults receiving intravenous iron, a panel of 10 Canadian clinical experts developed a practical algorithm for the identification and management of hypersensitivity reactions to intravenous iron.
Materials and methods
A systematic search of PubMed to February 2018 was performed. Articles related to hypersensitivity reactions were selected for review. The algorithm was developed during a 1‐day live meeting based on the literature review and clinical expertise where evidence was lacking. The algorithm was then refined through an iterative process involving a web‐based platform and virtual meetings.
Results
The algorithm provides guidance to healthcare professionals in preparing for and administering IV iron, as well as recognizing and managing hypersensitivity reactions to intravenous iron. Considerations for re‐challenging patients who have experienced prior reactions are provided.
Conclusion
Healthcare professionals who are involved in the care of patients receiving intravenous iron should be trained to anticipate, recognize and manage hypersensitivity reactions to intravenous iron to optimize patient care.

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