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

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Abstract
Introduction: Laryngopharyngeal dysesthesia is considered an acute peripheral neuropathy secondary to oxaliplatin neurotoxicity. Case report: We report a case of laryngopharyngeal dysesthesia that developed in a patient with colon adenocarcinoma after receiving her third cycle of oxaliplatin. Management & outcome: She 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. Discussion: Laryngopharyngeal 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.

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