Laryngopharyngeal dysesthesia as a possible clinical manifestation of a cytokine release reaction due to oxaliplatin.

Abstract

IntroductionLaryngopharyngeal dysesthesia is considered an acute peripheral neuropathy secondary to oxaliplatin neurotoxicity.Case reportWe report a case of laryngopharyngeal dysesthesia that developed in a patient with colon adenocarcinoma after receiving her third cycle of oxaliplatin.Management & outcomeShe was treated with antihistamines, steroids, oxygen, and adrenaline and referred to the allergy department for investigation of a hypersensitivity reaction to the drug. Skin tests and tryptase extracted after the acute episode ruled out this possibility. However, the patient presented a slight elevation of interleukin 6, commonly observed in cytokine release reactions. The patient continued her oxaliplatin treatment with cautious administration and under the supervision of the allergist.DiscussionLaryngopharyngeal dysesthesia is part of oxaliplatin neurotoxicity and does not require discontinuation of the drug. However, in patients with severe laryngopharyngeal dysesthesia symptoms, it would be advisable to perform a differential diagnosis with hypersensitivity reactions and cytokine release reactions, whose management differs from neurotoxic reactions.