Incidence and associated factors of cetuximab-induced hypersensitivity infusion reactions in 1392 cancer patients treated in four French areas: a possible association with Lyme disease?

BACKGROUND: Previous studies have observed an increased incidence of Cetuximab-induced hypersensitivity infusion reactions (CI-IRs) in the southeastern states of the USA. Tick's bites were suspected of generating cross-reactions between cetuximab and alpha-gal. This study aims was to describe the incidence and associated risk factors of CI-IRs, in the French areas chosen according to their Lyme disease incidence. PATIENTS AND METHODS: A retrospective chart review was conducted on patients that received cetuximab infusion from January 2010 to June 2019 in 4 French areas with different Lyme disease incidence rates. RESULTS: Of 1392 patients, 117 (8.4%) experienced a CI-IR, including 68 severe (grade 3 or 4) reactions (4.9%). This CI-IR incidence was significantly higher in the Lyme disease high-risk area than in the other areas (13.2% versus 7.1%, 8.1% and 6.4%; P = 0.016). Sex (P = 0.53), premedication (P = 0.91), primary cancer location (P = 0.46) and chemotherapy regimen type (P = 0.78) had no impact on CI-IR incidence in the overall population. In the head and neck squamous cell carcinoma (HNSCC) patient subgroup, CI-IRs were significantly more frequent in the high-risk area (16.4% versus 6.7%, 7.1% and 7.0%; P = 0.0015). CONCLUSION: This study suggests that patients treated in the French area with the highest incidence of Lyme disease are at a higher risk of CI-IRs.

[The chronic constrictive pericarditis, a real calcified gangue realizing a mid-ventricular bottleneck: A case report]. / La péricardite chronique constrictive, une véritable gangue calcifiée réalisant un goulot d'étranglement médio-ventriculaire : à propos d'un cas.

A 30-year-old woman consulted for a predominantly right-sided global heart failure chart that had been evolving for about 3 months. Its antecedents include a concept of poorly treated pleuropulmonary tuberculosis at the age of 8 years. Lateral chest X-ray, transthoracic echocardiography and thoracic CT showed ventricular ring calcification with mid-ventricular compression with apical ballooning. The diagnosis of chronic mid-ventricular constrictive pericarditis of tuberculosis etiology was retained. The patient was put on diuretic treatment and the immediate evolution is favorable with a regression of the signs of congestion. Surgical decortication has been indicated.