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The Journal of Allergy and Clinical... May 2024When approaching a case of apparent drug allergy, the consulting clinician should consider a broad differential diagnosis. This article presents a series of cases that...
When approaching a case of apparent drug allergy, the consulting clinician should consider a broad differential diagnosis. This article presents a series of cases that could be commonly referred to an allergist for assessment as "drug allergy," however, a real diagnosis exists that mandates a different diagnostic and treatment strategy, including a case of inducible laryngeal obstruction, multiple drug intolerance syndrome, viral rash, seizure due to metastatic malignancy, and hemophagocytic lymphohistiocytosis initially diagnosed as drug reaction and eosinophilia with systemic symptoms. The initial misdiagnoses of these patients delayed or interfered with their medical care, emphasizing the importance of accurate diagnoses for the benefit of our patients.
Topics: Humans; Diagnosis, Differential; Female; Male; Drug Hypersensitivity; Middle Aged; Lymphohistiocytosis, Hemophagocytic; Adult; Aged; Diagnostic Errors; Drug Hypersensitivity Syndrome
PubMed: 38325764
DOI: 10.1016/j.jaip.2024.01.047 -
Pediatric Allergy and Immunology :... Dec 2019The European Academy of Allergy and Clinical Immunology (EAACI) supports three journals: "Allergy," "Pediatric Allergy and Immunology (PAI)," and "Clinical and... (Review)
Review
The European Academy of Allergy and Clinical Immunology (EAACI) supports three journals: "Allergy," "Pediatric Allergy and Immunology (PAI)," and "Clinical and Translational Allergy (CTA)." One of the major goals of EAACI is to support health promotion in which prevention of allergy and asthma plays a critical role and to disseminate the knowledge of allergy to all stakeholders including the EAACI junior members. This paper summarizes the achievements of 2018 in anaphylaxis, and food and drug allergy. Main topics that have been focused are anaphylaxis, mechanisms of food allergy (FA), epidemiology of FA, food allergens, diagnosis of FA, prevention and control of FA, FA immunotherapy, drug allergy, and political agenda.
Topics: Allergy and Immunology; Anaphylaxis; Animals; Desensitization, Immunologic; Drug Hypersensitivity; Europe; Food Hypersensitivity; Humans; Information Dissemination; Societies, Scientific
PubMed: 31539176
DOI: 10.1111/pai.13125 -
Revista Alergia Mexico (Tecamachalco,... Apr 2023Any substance used as a treatment for any disease can produce harmful or unpleasant events called adverse drug reactions (ADRs). They are due to inherent biological... (Review)
Review
BACKGROUND
Any substance used as a treatment for any disease can produce harmful or unpleasant events called adverse drug reactions (ADRs). They are due to inherent biological effects of the drug and are caused by immunological and non-immunological mechanisms.
OBJECTIVES
To describe the immunological mechanisms of hypersensitivity reactions (HSR) to drugs, their epidemiology, risk factors, classification, clinical manifestations, diagnosis, treatment, and prognosis.
METHODS
A review of the most current literature in English and Spanish was carried out, in the main databases, related to the HSR of various drug groups.
RESULTS
This study describes the terms used to define ADRs and HSRs, their classification and clinical manifestations, current diagnostic tools, treatment algorithms and prognosis of the most frequently used medications and with the highest prevalence of reported adverse events.
CONCLUSION
ADRs are a challenging entity, with a complex pathophysiology that has not been fully understood. Its approach requires a careful consideration since not all drugs have validated tests for their diagnosis nor a specific treatment. When indicating the use of any drug, the severity of the disease, the availability of other treatments and the potential risks of developing future adverse events should always be taken into consideration.
Topics: Humans; Drug Hypersensitivity; Drug-Related Side Effects and Adverse Reactions; Prevalence
PubMed: 37218047
DOI: 10.29262/ram.v69i4.1181 -
The Journal of Allergy and Clinical... 2019This review focuses on advances in health information technology in the detection, diagnosis, and management of drug allergy. The data regarding the use of electronic... (Review)
Review
This review focuses on advances in health information technology in the detection, diagnosis, and management of drug allergy. The data regarding the use of electronic health records and social media for the detection of drug allergy are reviewed, along with predictive algorithms and clinical decision support systems for drug allergy diagnosis. Drug allergy pathways, algorithms, computerized decision support systems, and computerized physician order entry for patient management are discussed. The use of electronic consults (e-consults) and telehealth in this field is described, as are efforts to improve communication among patients and providers. Future directions for research are suggested.
Topics: Allergy and Immunology; Decision Support Systems, Clinical; Delivery of Health Care; Documentation; Drug Hypersensitivity; Electronic Health Records; Humans; Medical Informatics; Medical Order Entry Systems; Remote Consultation; Skin Tests
PubMed: 31108217
DOI: 10.1016/j.jaip.2019.04.050 -
The Medical Clinics of North America Jul 1992Although allergic drug reactions are just one type of adverse reaction to medications, they are clinically very important because of the morbidity and mortality they... (Review)
Review
Although allergic drug reactions are just one type of adverse reaction to medications, they are clinically very important because of the morbidity and mortality they cause. An ever-expanding pharmacopeia increases the potential for allergic drug reactions. An understanding of the types of allergic drug reactions, their immunopathologic mechanisms, and the most likely medications involved; an approach to determine the drug responsible for the reaction; and ways to prevent future allergic drug reactions are important features in minimizing patient morbidity.
Topics: Desensitization, Immunologic; Drug Hypersensitivity; Humans; Intraoperative Complications; Medical History Taking; Radioallergosorbent Test; Skin Tests
PubMed: 1614237
DOI: 10.1016/s0025-7125(16)30329-7 -
Handbook of Experimental Pharmacology 2022Allergy or hypersensitivity to drugs often affects the skin and sometimes also mucosa. While immediate type reactions show a rather homogeneous pattern, delayed type...
Allergy or hypersensitivity to drugs often affects the skin and sometimes also mucosa. While immediate type reactions show a rather homogeneous pattern, delayed type reactions reveal a high variability. In both cases it may not always be easy to differentiate drug reactions from non-drug-induced skin conditions. Furthermore, the different types of cutaneous adverse reactions may be difficult to distinguish in the beginning. This accounts predominately for delayed hypersensitivity reactions that can occur after a variety of medications and present with manifold lesions. Most of these cutaneous adverse reactions are mild, but some are severe with high morbidity and mortality. In the clinical setting, it is important to recognize the signs that point to a more severe condition early on in order to initiate appropriate management. In addition, it is crucial to identify the potentially culprit medication on the basis of a detailed medication history and by evaluating the relevant exposure times of certain drugs that differ substantially between the various reaction types. After the acute stage of the adverse reaction is managed successfully, further allergologic testing may be undertaken to confirm the offending drug.
Topics: Drug Hypersensitivity; Humans; Skin; Skin Tests
PubMed: 34219202
DOI: 10.1007/164_2021_490 -
Pediatric Annals Oct 2018Drug allergy is commonly encountered in clinical practice. It is an immunological response to a pharmaceutical agent. The clinical presentation can vary from mild...
Drug allergy is commonly encountered in clinical practice. It is an immunological response to a pharmaceutical agent. The clinical presentation can vary from mild cutaneous reactions to life-threatening conditions such as Stevens-Johnson syndrome and toxic epidermal necrolysis. Diagnosis is most often clinical, but investigations such as measurement of immunoglobulin E, patch testing, and skin biopsy may be required. In patients with a known drug allergy, the offending drug should be avoided. [Pediatr Ann. 2018;47(10):e419-e425.].
Topics: Drug Hypersensitivity; Humans; Skin
PubMed: 30308679
DOI: 10.3928/19382359-20180920-02 -
Pediatric Allergy and Immunology :... May 2023
Topics: Humans; Child; Drug Hypersensitivity; Anti-Bacterial Agents
PubMed: 37232287
DOI: 10.1111/pai.13957 -
The Journal of Allergy and Clinical... Jan 2019Despite their low frequency, drug hypersensitivity reactions (DHRs) can be serious and result in lifelong sequelae. The diagnosis is critical to avert future reactions... (Review)
Review
Despite their low frequency, drug hypersensitivity reactions (DHRs) can be serious and result in lifelong sequelae. The diagnosis is critical to avert future reactions and should identify the culprit drug or drugs and safe alternatives. However, making the diagnosis can be complex and challenging. Reliable in vitro tests can offer the potential to improve a diagnosis of DHR and influence medical decision making. Importantly, in vitro testing is frequently not performed as a test in isolation but rather as a component of a diagnostic algorithm along with additional tests. There are several in vitro approaches for the different endotypes of DHRs. However, only few are available for routine diagnosis, and many are restricted to research laboratories. In vitro tests exhibit varying sensitivity and specificity depending on the drug involved and the clinical phenotype. In vitro tests can complement skin tests, especially in patients with negative or equivocal skin test responses inconsistent with the clinical presentation and in severe reactions in which drug provocation tests are contraindicated. The main unmet need for many in vitro tests for the diagnosis of DHRs is validation in larger studies with standardized controls that could harmonize diagnostic management between the United States, European Union, and other regions of the world.
Topics: Animals; Clinical Decision-Making; Drug Hypersensitivity; Humans; Skin Tests
PubMed: 30573343
DOI: 10.1016/j.jaci.2018.09.022 -
Pediatric Clinics of North America Oct 1988Adverse reaction to drugs is a common problem in the pediatric population. This article discusses the different types of adverse drug reactions and their mechanisms.... (Review)
Review
Adverse reaction to drugs is a common problem in the pediatric population. This article discusses the different types of adverse drug reactions and their mechanisms. Also included are representative clinical syndromes of drug hypersensitivity reactions, as well as certain organ systems syndromes. Finally, diagnosis and management of allergic reactions to particular drugs such as penicillin, iodinated contrast dye, insulin, and others are discussed.
Topics: Anaphylaxis; Drug Eruptions; Drug Hypersensitivity; Drug-Related Side Effects and Adverse Reactions; Humans; Insulin; Penicillins
PubMed: 2971921
DOI: 10.1016/s0031-3955(16)36553-1