2079 Jessner-Kanoff Lymphocytic Infiltrate As a Side Effect of Immunotherapy

Monday, 5 December 2011
Poster Hall (Cancún Center)

Arzu Didem Yalcin, MD , Allergology and Clinical Immunology Unit, Antalya Education and Training Hospital, Antalya, Turkey

Atil Bisgin, MD, PhD , Human Gene and Cell Therapy Center of Akdeniz University Hospital and Clinics, Antalya, Turkey

Reginald M Gorczynski, MD, PhD , Division of Cellular & Molecular Biology, Toronto Hospital, University Health Network, Toronto, ON, Canada

Ayse Akman , Dept. Of Dermatology, Akdeniz University Faculty of Medicine, Antalya, Turkey

Gülgün ErdoĞan , Department of Pathology, Akdeniz University Faculty of Medicine, Antalya, Turkey

Olcay Yegin , Dept. Of Immunology and Allergy, Akdeniz University Faculty of Medicine, Antalya , Turkey

Background:

Allergen immunotherapy has been used in the management of allergic diseases for nearly 100 years. It is the only specific treatment for hymenoptera venom anaphylaxis. Various venom immunotherapy schedules have been designed to treat anaphylaxis. Although the effect of venom immunotherapy is well documented, there is also an increased risk of side-effects in bee-venom-treated patients and in those with rapid dose increase.

Methods:

This report describes the first case of a patient in the literature with Jessner’s Lymphocytic infiltration as a side effect of venom immunotherapy. This is a chronic, benign, T cell pseudolymphoma characterized by the occurrence of recurrent, asymptomatic, smooth, erythematous, non-scaling papules or plaques. However, the exact cause of Jessner's Lymphocytic Infiltration is unknown.

Results:

The case here reported was a 61 year-old male pediatrician, who has been followed by at our Immunology Service because of an immediate allergy to a bee sting managed with venom immunotherapy. His chief complaint was an anaphylactic reaction after 5 minutes of a bee sting. The onset of his symptoms was gradual and began just 25 minutes after the sting. The venom immunotherapy regimen was planned and the protocol immediately began without premedication. But during the initial phases of treatment, on the third dose of immunotherapy, he reported severe itching. After complaining of itching, many erythematous papules and plaques on his chest were developed . The lesions flared up for 3 days period just after injection and decreased afterwards. The type of lesions and their location supported the diagnosis of Jessner disease, which had also a histopathological confirmation.

Conclusions:

We herein report this case to call attention to this side effect of VIT that  there may be more similar cases never been reported.