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Anaphylaxis after treatment with recombinant factor VIII: investigation and therapeutic challenge
  1. Sofia Pires1,
  2. Teresa Sevivas2,
  3. Carla Chaves Loureiro1 and
  4. Borja Bartholomé3
  1. 1 Pediatric Department, Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  2. 2 Haematology Department, Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  3. 3 Application Lab, R&D Department, Roxall Group, Bilbao, Spain
  1. Correspondence to Dr Sofia Pires, sofia.pires88{at}


We report a 10-year-old patient with haemophilia A developing anaphylaxis to recombinant factor VIII (octocog alfa). Allergic reactions, and especially anaphylactic events, are rare in patients with haemophilia A. The nature of these reactions is not fully understood. Here, we demonstrate a type I hypersensitivity reaction using sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunoblotting assay. This test revealed itself as an essential diagnostic tool, as it allowed us to choose an alternative treatment (moroctocog alfa). Its safety was later confirmed by an uneventful challenge test.

  • paediatrics (drugs and medicines)
  • unwanted effects/adverse reactions
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  • Patient consent for publication Obtained.

  • Contributors All authors contributed to the actual manuscript. SP drafted the initial manuscript. TS and CCL reviewed and revised the manuscript. BB helped with the SDS-PAGE immunoblotting assay interpretation and also reviewed the manuscript. All authors have sent and approved the submission of this version of the manuscript and take full responsibility for the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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