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Drug hypersensitivity reaction

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https://www.readbyqxmd.com/read/27924646/influence-of-anti-tnf-immunogenicity-on-safety-in-rheumatic-disease-a-narrative-review
#1
Andrea Matucci, Daniele Cammelli, Fabrizio Cantini, Delia Goletti, Valentina Marino, Giuseppe Maria Milano, Raffaele Scarpa, Giuliano Tocci, Enrico Maggi, Alessandra Vultaggio
Tumor necrosis factor-alpha (TNF-α) antagonists have been shown to be effective in the treatment of chronic inflammatory rheumatic conditions. The use of anti-TNF agents, combined with improved diagnosis, aggressive regimens and regular monitoring, have substantially improved patient outcomes. However, all biological agents are immunogenic, resulting in the formation of anti-drug antibodies (ADAs), which can neutralize drug activity leading to loss of response and potential relapse. In addition, ADAs can also cause serious adverse events such as infusion hypersensitivity reactions...
December 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27910104/long-term-reproducibility-of-positive-patch-test-reactions-in-patients-with-non-immediate-cutaneous-adverse-drug-reactions-to-antibiotics
#2
André Pinho, Ana Marta, Inês Coutinho, Margarida Gonçalo
BACKGROUND: As in contact allergy, T cell-mediated hypersensitivity in non-immediate (NI) cutaneous adverse drug reactions (CADRs) to antibiotics is considered to be lifelong, but, in this setting, patch tests have rarely been repeated after long time intervals. OBJECTIVE: To evaluate the long-term reproducibility of positive patch test reactions to antibiotics in patients with NI CADRs. METHODS: Fifty-six patients with NI CADRs to antibiotics who had relevant positive reactions during patch testing were invited to repeat patch tests with a similar antibiotic series 2-15 years thereafter...
December 2, 2016: Contact Dermatitis
https://www.readbyqxmd.com/read/27893591/endophthalmitis-in-a-patient-treated-with-bacillus-calmette-gu%C3%A3-rin-immunotherapy
#3
Julie Vadboncoeur, Sébastien Olivier, Hafid Soualhine, Annie-Claude Labbé, Marie-Lyne Bélair
BACKGROUND: Intravesical Bacillus Calmette-Guérin (BCG) instillation has become one of the mainstays of adjunctive therapy in the treatment of superficial bladder cancer. Ophthalmologic complications are rare, but few cases are reported in the literature. METHODS: Retrospective observational case report. RESULTS: The authors report a case of unilateral Mycobacterium bovis BCG endophthalmitis after intravesical BCG instillations. Despite appropriate systemic antituberculous and corticosteroid therapy, the patient almost completely lost sight in the affected eye...
November 23, 2016: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/27891350/hypersensitivity-with-inhalational-budesonide-an-under-recognised-entity
#4
Pramod Kumar Sharma, Neeraj Gupta, Najmul Hasan, Bhaskar Krishnamurthy, Surjit Singh
Hypersensitivity reactions are commonly encountered with drugs such as beta lactams, sulphonamides, allopurinol etc., Corticosteroids are frequently employed in the treatment of drug induced allergic reactions. Therefore, it is highly unlikely that a corticosteroid itself may cause such a reaction as an adverse effect. We had encountered a rare case of hypersensitivity reaction with inhalational budesonide in an eight-year-old boy. The patient developed maculopapular rashes over the back, buttocks and legs accompanied with pruritus within four hours of administration of the first dose...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27889746/distinct-in-vitro-complement-activation-by-various-intravenous-iron-preparations
#5
Julia Cordelia Hempel, Felix Poppelaars, Mariana Gaya da Costa, Casper F M Franssen, Thomas P G de Vlaam, Mohamed R Daha, Stefan P Berger, Marc A J Seelen, Carlo A J M Gaillard
BACKGROUND: Intravenous (IV) iron preparations are widely used in the treatment of anemia in patients undergoing hemodialysis (HD). All IV iron preparations carry a risk of causing hypersensitivity reactions. However, the pathophysiological mechanism is poorly understood. We hypothesize that a relevant number of these reactions are mediated by complement activation, resulting in a pseudo-anaphylactic clinical picture known as complement activation-related pseudo allergy (CARPA). METHODS: First, the in-vitro complement-activating capacity was determined for 5 commonly used IV iron preparations using functional complement assays for the 3 pathways...
November 26, 2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27888028/identifying-allergic-drug-reactions-through-placebo-controlled-graded-challenges
#6
Melissa Iammatteo, Denisa Ferastraoaru, Rebecca Koransky, Santiago Alvarez-Arango, Niharika Thota, Ayobami Akenroye, Elina Jerschow
BACKGROUND: Graded challenges are performed to exclude hypersensitivity reactions in patients with a low likelihood of drug allergy. Literature regarding optimal protocols with a defined number of steps and use of placebo is lacking. OBJECTIVE: To identify allergic drug reactions (ADRs) through a 3-step protocol composed of placebo followed by a 2-step graded drug challenge. METHODS: We performed a 5-year retrospective chart review of all patients with historical ADRs who underwent single-blind, placebo-controlled graded drug challenges between October 2010 and November 2015 at an outpatient drug allergy clinic...
November 22, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27886905/cutaneous-manifestation-of-drug-allergy-and-hypersensitivity
#7
REVIEW
Anna Zalewska-Janowska, Radoslaw Spiewak, Marek L Kowalski
Drug hypersensitivity reactions may manifest with either organ-specific or systemic symptoms, but cutaneous eruptions are the most common manifestations. Different medications may cause identical skin symptoms, whereas hypersensitivity to a single drug may manifest with various patterns of symptoms depending on the pathomechanism of hypersensitivity. Drug reactions should be also taken into account in the differential diagnosis of numerous skin rashes. Analysis of morphology of drug-induced lesions, about potential immunologic or nonimmunological mechanisms, is important for the final diagnosis...
February 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27882527/diclofenac-induced-allergic-contact-dermatitis-a-series-of-four-patients
#8
Sandra Jerkovic Gulin, Anca Chiriac
Allergic contact dermatitis is an immune-mediated antigen-specific skin reaction to an allergenic chemical that corresponds to a delayed-type hypersensitivity response (type IV reaction). Allergic contact dermatitis should be suspected when skin lesions are localized to the site of previous applications of the culprit drug. Lesions appear after re-exposure in susceptible persons, with delayed onset (more than 24 h after exposure). The gold standard for diagnosis is patch (epicutaneous) testing; identification and removal of any potential causal agents is crucial...
December 2016: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27879435/identification-of-mhc-haplotypes-associated-with-drug-induced-hypersensitivity-reactions-in-cynomolgus-monkeys
#9
Hong Wu, Jessica Whritenour, Jonathan C Sanford, Christopher Houle, Karissa K Adkins
Drug-induced hypersensitivity reactions can significantly impact drug development and use. Studies to understand risk factors for drug-induced hypersensitivity reactions have identified genetic association with specific human leukocyte antigen (HLA) alleles. Interestingly, drug-induced hypersensitivity reactions can occur in nonhuman primates; however, association between drug-induced hypersensitivity reactions and major histocompatibility complex (MHC) alleles has not been described. In this study, tissue samples were collected from 62 cynomolgus monkeys from preclinical studies in which 9 animals had evidence of drug-induced hypersensitivity reactions...
November 22, 2016: Toxicologic Pathology
https://www.readbyqxmd.com/read/27865769/discrepancies-in-the-diagnosis-and-classification-of-nonsteroidal-anti-inflammatory-drug-hypersensitivity-reactions-in-children
#10
Tuğba Arikoglu, Gulen Aslan, Didem Derici Yildirim, Sehra Birgul Batmaz, Semanur Kuyucu
BACKGROUND: Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently encountered in daily clinical practice. The aim of this study was to determine the confirmation rates, risk factors of NSAID hypersensitivity in children and to try to classify them with a standardized diagnostic protocol. METHODS: All patients with a suspicion of NSAID-induced hypersensitivity were evaluated with European Network for drug Allergy (ENDA) recommendations...
November 16, 2016: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/27865673/a-rare-cause-of-acute-coronary-syndrome-kounis-syndrome
#11
João Almeida, Sara Ferreira, Joana Malheiro, Paulo Fonseca, Daniel Caeiro, Adelaide Dias, José Ribeiro, Vasco Gama
Kounis syndrome is an acute coronary syndrome in the context of a hypersensitivity reaction. The main pathophysiological mechanism appears to be coronary vasospasm. We report the case of a patient with a history of allergy to quinolones, who was given ciprofloxacin before an elective surgical procedure and during drug administration developed symptoms and electrocardiographic changes suggestive of ST-segment elevation acute coronary syndrome. The drug was suspended and coronary angiography excluded epicardial coronary disease...
December 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27864093/skin-testing-and-drug-challenge-outcomes-in-antibiotic-allergic-patients-with-immediate-type-hypersensitivity
#12
Stephanie L Mawhirt, Luz S Fonacier, Rose Calixte, Mark Davis-Lorton, Marcella R Aquino
BACKGROUND: The evaluation of antibiotic immediate-type hypersensitivity is intricate because of nonstandardized skin testing and challenge method variability. OBJECTIVE: To determine the safety outcomes and risk factors for antibiotic challenge reactions in patients reporting a history of antibiotic immediate-type hypersensitivity. METHODS: A 5-year retrospective review of patients evaluated for immediate-type antibiotic allergy was conducted...
November 15, 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27859495/drug-specific-hypophosphatemia-and-hypersensitivity-reactions-following-different-intravenous-iron-infusions
#13
Palle Bager, Christian L Hvas, Jens F Dahlerup
AIMS: Intravenous (IV) iron infusions have been associated with hypophosphatemia (HP) and hypersensitivity reactions (HSRs). No studies have compared the side effects of ferric carboxymaltose (FCM) with those of isomaltoside 1000 (ISM). This study aimed to describe the occurrence of HP and HSRs following the administration of either FCM or ISM. METHODS: Data on 231outpatients treated with IV iron infusions, between November 2011 and April 2014, were collected. During that period, the department made a switch from FCM to ISM and then back to FCM...
November 17, 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27857897/interleukin-4-and-interferon-%C3%AE-are-possible-allergic-markers-in-pediatric-patients-with-%C3%AE-lactam-hypersensitivity
#14
Khaled H Mahmoud, Abdullateef A Alzolibani, Zafar Rasheed, Yasser Farouk, Ghada Bin Saif, Ahmad A Al Robaee
BACKGROUND: β-lactam agents are known to elicit T-cell-mediated immune responses that play a central role in the onset of allergic reactions, but the involvement of specific type of cytokines in drug allergy remains largely unexplored in humans. OBJECTIVES: This study was undertaken to investigate the role of cytokines involvement in pediatric patients with β-lactam hypersensitivity and to determine whether involvement of cytokines in drug-mediated reactions are important for the perspective of allergic patient's management...
October 2016: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/27856924/prevention-of-carboplatin-induced-hypersensitivity-reactions-in-women-with-ovarian-cancer
#15
Katarzyna J Jerzak, Shaidah Deghan Manshadi, Pamela Ng, Manjula Maganti, Jeanna M McCuaig, Marcus Bulter, Amit Oza, Helen J Mackay
BACKGROUND: Carboplatin-based chemotherapy offers high response rates and improved overall survival for women with epithelial ovarian cancer, but its use is limited by the occurrence of hypersensitivity reactions. To evaluate the efficacy of prophylactic diphenhydramine for hypersensitivity reaction prevention, we reviewed the incidence of hypersensitivity reactions and identified patients at high risk of hypersensitivity reactions. METHODS: Women receiving ≥6 cycles of carboplatin-based chemotherapy for epithelial ovarian cancer were identified from our institutional database at the Princess Margaret Cancer Centre...
November 17, 2016: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/27852432/febuxostat-hypersensitivity-another-cause-of-dress-syndrome-in-chronic-kidney-disease
#16
E Paschou, E Gavriilaki, G Papaioannou, A Tsompanakou, A Kalaitzoglou, N Sabanis
Febuxostat is a xanthine oxidase inhibitor that during the last years has successfully replaced allopurinol treatment in patients with chronic kidney disease (CKD) and hyperuricemia. Several adverse events have been observed during therapy with febuxostat. DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome induced by febuxostat has been poorly described, mainly in patient with CKD who previously developed allopurinol hypersensitivity syndrome. DRESS syndrome is characterized by manifold cutaneous reactions and systemic disorders with potential devastating consequences...
November 2016: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27852424/hypersensitivity-to-beta-lactam-antibiotics-a-three-year-study
#17
I Mota, Â Gaspar, M Chambel, S Piedade, M Morais-Almeida
BACKGROUND: Beta-lactams antibiotics (BL) are the most frequent elicitors of allergic drug reactions. The aim of our study was to characterize the patients referred with suspected hypersensitivity (HS) to BL. METHODS: Over a three-year period (2011-2013), a total of 234 adult and paediatric patients (pts) with suspected HS to BL were investigated according to the European Network for Drug Allergy guidelines. RESULTS: HS to BL was confirmed in 43 pts (18%), without differences between adult and paediatric pts; anaphylaxis was reported by 20 pts...
November 2016: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27834127/hypersensitivity-reactions-from-excipients-in-systemic-glucocorticoid-formulations
#18
Gianfranco Calogiuri, Lene H Garvey, Paolo Romita, Luigi Macchia, Caterina Foti
Glucocorticoids are the most widely used drugs for the treatment of hypersensitivity, however these drugs themselves and the excipients contained in commercial corticosteroid formulations are able to induce severe immediate-type hypersensitivity reactions. Reactions involving excipients have been confirmed to be IgE mediated by the demonstration of specific-IgE to excipients such as carboxymethylcellulose and lactose. In case of hypersensitivity reactions to corticosteroid preparations, a complete allergy work-up with skin tests and/or challenge tests should include testing excipients as well as the active ingredients...
November 9, 2016: Anti-inflammatory & Anti-allergy Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/27832658/anaphylaxis-to-over-the-counter-flurbiprofen-in-a-child
#19
Mattia Giovannini, Lucrezia Sarti, Simona Barni, Neri Pucci, Elio Novembre, Francesca Mori
Non-steroidal anti-inflammatory drugs are suspected to cause drug hypersensitivity very frequently in paediatric patients. In this article, we describe the first case of anaphylaxis to flurbiprofen in a child and provide insight into the possibility of severe reactions and even anaphylaxis to over-the-counter flurbiprofen. Finally, the importance of a rigorous allergy work-up in reaching a confident diagnosis and providing the patient with a safe alternative is shown.
November 11, 2016: Pharmacology
https://www.readbyqxmd.com/read/27829334/cellular-tests-for-the-evaluation-of-drug-hypersensitivity
#20
Adriana Ariza, Maria I Montañez, Tahia D Fernández, James R Perkins, C Mayorga
The diagnosis of drug hypersensitivity reactions (DHR) is complex, with many potential pitfalls. Although the use of clinical history and skin testing can be valuable, drug provocation testing (DPT) remains the gold standard for many DHR. However, DPT carries some potential risk and should not be performed for severe reactions. There is therefore a general consensus on the need for in vitro tests to achieve safe and accurate diagnosis of DHR. A range of in vitro approaches can be applied depending on the type of reaction and the immunological mechanism involved, i...
November 7, 2016: Current Pharmaceutical Design
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