Anakinra Hypersensitivity Reaction in a Paediatric Patient with Autoinflammatory Syndrome

Dear Editor, Autoinflammatory diseases are a group of genetic disorders characterized by recurrent episodes of inflammatory manifestations that can affect many organs; in some of these disorders treatment with anakinra, a recombinant IL-1 receptor antagonist that blocks the proinflammatory effects of IL-1β, has shown efficacy [1, 2]. Although local reactions are well known among the adverse effects of anakinra [3], some cases of hypersensitivity reactions have been reported [4, 5]. We report the case of a 3-year-old girl undergoing rheumatology follow-up for an autoinflammatory syndrome with recurrent flares initially managed with corticosteroids. Specific diagnosis had not been achieved even after exhaustive genetic study, but the clinical features (fever, pustular rash, non-bacterial osteitis, pericardial effusion) permitted suspicion of an IL-1 mediated disease. Empirical treatment was started with anakinra (Kineret, 100 mg/0.67 ml), as a solution for subcutaneous injection in a pre-filled syringe...