#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Drug Hypersensitivity Reactions: Diagnosis and Treatment (Part II)


Authors: J. Nemšovská
Authors‘ workplace: Dermatovenerologická klinika LF UK a UNB, Bratislava, prednostka prof. MUDr. Mária Šimaljaková, PhD., MPH, MHA
Published in: Čes-slov Derm, 94, 2019, No. 5, p. 192-201
Category: Reviews (Continuing Medical Education)

Overview

The diagnosis of drug hypersensitivity reactions (DHRs) is primarily based on a thorough case history, skin tests and drug provocation tests (challenge tests) in indicated cases. Skin tests are integral to the culprit drug diagnostics. Skin prick tests (SPT) and intradermal tests (IDT) are recommended for immediate-type hypersensitivity reactions and patch test and late-reading IDT for delayed-type hypersensitivity reactions. In vitro tests can provide valuable additional information and yield decisive results for the diagnosis, especially in cases of severe drug reactions, when provocation tests are contraindicated. In vitro tests can either help to diagnose the DHR itself or to identify the culprit drug. Determination of tryptase, histamine and its metabolits, PAF (Platelet activating factor) and CPA3 (Carboxypeptidase A3) in immediate-
-type DHRs and the cellular analysis of skin biopsies and peripheral blood in delayed-type DHRs belong to the first group of tests. The most commonly used tests to identify the culprit drug is determination of specific IgE, Basophil activation test, Lymphocyte transformation test and HLA allele determination. Treatment is based on permanent avoidance of the culprit drug and replacement for a structurally different, non-cross-reacting compound if needed. Drug desensitization represents a treatment option in cases, where there is no alternative drug available.

Keywords:

diagnosis – drug hypersensitivity – skin test – in vitro test – provocation test – desensitization


Sources

1. ABERER, W., BIRCHER, A., ROMANO, A. et al. Drug provocation testing in the dignosis of drug hypersensitivity reactions: general considerations. Allergy, 2003, 58(9), p. 856–863.

2. BAHAR, M. A., SETIAWAN, D., HAK, E., WILFFERT, B. Pharmacogenetics of drug-drug interaction and drug-drug-gene interaction: a systematic rebiew on CYP2C9, CYP2C19, CYP2D6. Pharmacogenomics, 2017, 18(17), p. 701–739.

3. BARBAUD, A., COLLET, E., MILPIED, B. et al. A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions. Br. J. Dermatol., 2013, 168(3), p. 555–562.

4. BARTŮŇKOVÁ, J., PAULÍK, M. a kol. Vyšetřovací metody v imunologii. 2. vyd. Praha: Grada, 2011. 168 s. ISBN 978-80-247-3533-7.

5. BERROA, F., LAUFUENTE, A., JAVALOYES, G. et al. The usefulness of plasma histamine and different tryptase cut-off points in the diagnosis of peranae­sthetic hypersensitivity reactions. Clin. Exp. Allergy, 2014, 44, p. 270–277.

6. BROCKOW, K., ABERER, W., ATANASKOVIC--MARKOVIC, M. et al. Drug allergy passport and other documentation for patients with drug hypersensitivity – An ENDA/EAACI Drug Allergy Interest Group Position Paper. Allergy, 2016, 71, p. 1533–1539.

7. BROCKOW, K., GARVEY, L. H., ABERER, W. et al. Skin concentrations for systemically administred drugs – an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy, 2013, 68, p. 702–712.

8. BROCKOW, K., PRZYBILLA, B., ABERER, W. et al. Guideline for the diagnosis of drug hypersensitivity reactions. Allergo J. Int., 2015, 24(3), p. 94–105.

9. CASTELLS GUITART, M. C. Rapid drug desensitization for hypersensitivity reactions to chemotherapy and monoclonal antibodies in the 21st century. J. Invesig. Allergol. Clin. Immunol., 2014, 24(2), p. 72–79.

10. CERNADAS, J. R., BROCKOW, K., ROMANO, A. et al. General considerations on rapid desensitization for drug hypersensitivity – a consensus statement. Allergy, 2010, 65(11), p. 1357–1366.

11. DE GROOT, H., MULDER, W. M. C. Clinical practice. Drug desensitization in children. Eur. J. Pediatr., 2010, 169(11), p. 1305–1309.

12. DESCAMPS, V., BEN-SAID, B., SASSOLAS, B. et al. Management of drug reaction with eosinophilia and systemic symptoms (DRESS). Ann. Dermato. Venerol., 2010, 137, p. 703–708.

13. HRUBIŠKO, M. et al. Alergológia. Martin: Osveta, 2003. 519 s. ISBN 80-8063-110-7.

14. CHEN, CH. B., ABE, R., PAN, R. Y. et al. An Up--dated review of the Molecular Mechanisms in Drug Hypersensitivity. J. Immunol. Res., 2018, ID 6431694, 22 pages. Dostupné na www: https://doi.org/10.1155/2018/6431694.

15. CHUNG, W. H., HUNG, S. I., YANG, J. Y. et al. Granulysin is a key mediator for disseminated keratinocyte death in Stevens-Johnson syndrome and toxic epidermal necrolysis. Nat. Med., 2008, 12, p. 1343–1350.

16. JOHANSEN, J. D., FROSCH, P. J., LEPOITTEVIN, J. P. Contact Dermatitis. 5th Edition. Springer Berlin Heidelberg, 2011, ISBN 978-3-642-03827-3.

17. KATO, K., KAWASE, A., AZUKIZAWA, H. et al. Novel inerferon-γ enzyme-linked immunoSpot assay using activated cells for identifying hypersenitivity-inducing drug culprits. J. Dermatol. Sci., 2017, pii: S0923-1811(16)31063-5. doi: 10.1016/j.jdermsci.2017.03.007.

18. KOVÁČOVÁ, S. DIHS – liekmi indukovaný hypersenzitívny syndróm. Dermatol. Prax, 2014, 8(2), p. 40–64.

19. KOWALSKI, M. L., ASERO, R., BAVBEK, S. et al. Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal antiinflammatory drugs. Allergy, 2013, 68, p. 1219–1232.

20. LAŠŠÁNOVÁ, M., PETROVÁ, M., LAŠŠÁN, Š., HUDEC, R. Nežiaduce účinky liekov, riziko farmakoterapie. Via pract., 2008, 5(2), p. 87–89.

21. MAYORGA, C., CELIK, G., ROUZAIRE, P. et al. In vitro tests for drug hypersensitivity reactions: an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy, 2016, 71, p, 1103–1134.

22. MAYORGA, C., DONA, I., PEREZ-INESTROSA, E. et al. The value of in vitro tests to diminish drug challenges. Int. J. Mol. Sci., 2017, 18(6).

23. McNEIL, B. D., PUNDIR, P., MEEKER, S. et al. Identification of a mast-cell-specific receptor crucial for pseudo-allergic drug reactions. Nature, 2015, 519, p. 237–241.

24. MIN-HYE, K., JONG-MYUNG, L. Diagnosis and Management of Immediate Hypersensitivity Reactions to Cephalosporins. Allergy Asthma Immunol. Res., 2014, 6(6), p. 485–495.

25. MURARO, A., ROBERTS, G., WORM, M. et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy, 2014, 69, p. 1026–1045.

26. NEMŠOVSKÁ, J., ŠVECOVÁ, D. Hypersenzitívne reakcie vyvolané liekmi. Dermatol. Prax, 2017, 11(3), p. 112–116.

27. NEMŠOVSKÁ, J. Test aktivácie bazofilov u pacientov alergických na jed blanokrídleho hmyzu. Klinická imunológia a alergológia, 2016, 2, p. 11–17.

28. NEMŠOVSKÁ, J., ŠVECOVÁ, D. Precitlivenosť na jódové kontrastné látky. Dermatol. Prax., 2017, 11(1), p. 8–10.

29. OGAWA, K., MORITO, A., HASEGAWA, A. et al. Identification of thymus and activation-regulated chemokine (TARC/CCL17) as a potential marker for early indication of disease and prediction of disease activity in drug-induced hypersensitivity syndrome (DIHS)/drug rush with eosinophilia and systemic symptoms (DRESS). J. Dermatol. Sci., 2013, 69(1), p. 38–43.

30. PICHLER, W. J., HAUSMANN, O. Classification of Drug Hypersensitivity into Allergic, p-i, and Pseudo-Allergic Forms. Int. Arch. Allergy Immunol., 2016, 171, p. 166–179.

31. RAWLINS, M. D. Clinical pharmacology: adverse reactions to drugs. B. M. J., 1981, 282, p. 974–976.

32. RIEDL, M. A., CASILLAS, A. M.. Adverse drug reactions: types and treatment options. Am. Fam. Physician., 2003, 68(9), p. 1781–1790.

33. RODRIGUES, M. C. S., DE OLIVEIRA, C. Drug--drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review. Rev. Lat. Am. Enfermagen, 2016, 24, p. e 2800.

34. ROMANO, A., TORRES, M. J., CASTELLS, M. et al. Diagnosis and management of drug hypersensitivity reactions. J. Allergy Clin. Immunol., 2011, 127(3), p. S67–S73.

35. RUËFF, F., BILÓ, M. B., MŰLLER, U. R. Risk of severe anaphylaxis for patients with Hymenoptera venom allergy: Are angiotensin-receptor blockers comparable to angiotensin-converting enzyme inhibitors? Reply. J. Allergy Clin. Immunol., 2010, 125, p. 1171–1172.

36. SCHERER, K., BROCKOW, K., ABERER, W. Desensitization in delayed drug hypersensitivity reactions – an EAACI position paper of Drug Allergy Interest Group. Allergy, 2013, 68(7), p. 844–852.

37. SLANAŘ, O. Farmakogenomika – současnost, budoucnost, perspektiva. Klin. Farmakol. Farm., 2012, 26(3), p. 126–130.

38. SU, S. C., MOCKENHAUPT, P., WOLKENSTEIN, P. et al. Interleukin-15 is associated with severity and mortality in Stevens-Johnson syndrome/toxic epidermal necrolysis. J. Invest. Dermatol., 2017, 137, p. 1065–1073.

39. THOMAS, M., CRAWFORD, I. Best evidence topic report. Glucagon infusion in refractory anaphylactic shock in patients on beta-blockers. Emerg. Med. J., 2005, 22(4), p. 272–273.

40. TOLE, J. W., LIEBERMAN, P. Biphasic anaphylaxis review of incidence, clinical predictors, and observation recommendations. Immunol. Allergy Clin. North Am., 2007, 27(2), p. 319–326.

41. TORRES, M. J., ROMANO, A., CELIK, G. et al. Approach to the dignosis of drug hypersensitivity reactions: similarities and differences between Europe and North America. Clin. Transl. Allergy, 2017, 7, p. 7–25.

42. WHEATLEY, L. M., PLAUT, M., SCHWANINGER, J. M. et al. Report from the National Institute of Allergy and Infectious Diseases workshop on drug allergy. J. Allergy Clin. Immunol., 2015, 136(2), p. 262–271.

43. WÖHRL, S. NSAID hypersensitivity – recommendations for diagnostic work up and patient management. Allergo. J. Int., 2018, 27(4), p. 114–121.

44. ZIMMERMANN, S., SEKULA, P., VENHOFF, M. et al. Systemic immunomodulating therapies for Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review and metha-anylysis. JAMA Dermatology, 2017, 137(5), p. 514–522.

45. Zákon NR SR č. 362/2011 Z. z. o liekoch a zdravotníckych pomôckach a o zmene a doplnení niektorých zákonov, § 68 ods.1 a 2, 2011.

Labels
Dermatology & STDs Paediatric dermatology & STDs
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#