A Rare Hypersensitivity Reaction with Golimumab: Recurrent Fever After Each Injection Golimumab İlişkili Nadir Bir Hipersensitivite Reaksiyonu: Her Enjeksiyon Sonrası Tekrarlayan Ateş

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Günay B., MESCİ N., Külcü D. G., Özdemir M.

Turk Osteoporoz Dergisi, cilt.31, sa.2, ss.110-112, 2025 (Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 31 Sayı: 2
  • Basım Tarihi: 2025
  • Doi Numarası: 10.4274/tod.galenos.2025.26986
  • Dergi Adı: Turk Osteoporoz Dergisi
  • Derginin Tarandığı İndeksler: Scopus, CINAHL, EMBASE, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.110-112
  • Anahtar Kelimeler: Ankylosing spondylitis, golimumab, TNF-inhibitors, hypersensitivity, fever
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Ankylosing spondylitis (AS) is a chronic inflammatory disease treated with non-steroidal anti-inflammatory drugs (NSAIDs) and, in refractory cases, biologic agents such as tumor necrosis factor inhibitors (TNF-Is). While TNF-Is are generally well tolerated, rare hypersensitivity reactions may occur. We present a 31-year-old female diagnosed with AS, previously unresponsive to NSAIDs, who achieved remission with golimumab (50 mg/month) for six years. However, during the coronavirus disease-2019 pandemic, she began experiencing recurrent fever, fatigue, and elevated C-reactive protein levels 2-3 days post-injection. Extensive investigations, including antinuclear antibody, extractable nuclear antigen, antineutrophil cytoplasmic antibodies, and infectious serologies, were unremarkable. The symptoms resolved spontaneously within a week. Given the exclusion of infectious or autoimmune etiologies, a hypersensitivity reaction to golimumab was suspected. Treatment was switched to secukinumab, resulting in symptom resolution without further complications. Hypersensitivity reactions to TNF-Is, particularly fever, are rare but important adverse events. While similar reactions have been reported with infliximab, this is the first documented case associated with golimumab. Clinicians should be aware of this potential side effect to ensure prompt diagnosis and management. This case underscores the importance of vigilant monitoring for atypical adverse events during long-term biologic therapy in AS patients. Further research is needed to elucidate the pathophysiology and risk factors for hypersensitivity to TNF-Is.