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Allergy drug hypersensitivity

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https://www.readbyqxmd.com/read/29451619/increase-of-10-in-the-rate-of-adverse-drug-reactions-for-each-drug-administered-in-hospitalized-patients
#1
Marisa Rosimeire Ribeiro, Antonio Abílio Motta, Luiz Augusto Marcondes-Fonseca, Jorge Kalil-Filho, Pedro Giavina-Bianchi
OBJECTIVE: To assess the risk factors, incidence and severity of adverse drug reactions in in-patients. METHODS: This prospective study evaluated 472 patients treated at a teaching hospital in Brazil between 2010 and 2013 by five medical specialties: Internal Medicine, General Surgery, Geriatrics, Neurology, and Clinical Immunology and Allergy. The following variables were assessed: patient age, gender, comorbidities, family history of hypersensitivity, personal and family history of atopy, number of prescribed drugs before and during hospitalization, hospital diagnoses, days of hospitalization...
2018: Clinics
https://www.readbyqxmd.com/read/29432287/allergy-to-carbidopa
#2
Mariana Aurora Cansino-Torres, Valeria Sandoval-Rodríguez, Michel Sáenz-Farret, Carlos Zúñiga-Ramírez
BACKGROUND: D-Decarboxylase inhibitors, such as carbidopa or benserazide, have been used as adjunct therapy in Parkinson disease shortly after levodopa synthesis in the 1960s. These compounds increase intracerebral drug concentration and decrease adverse effects by blocking peripheral conversion to dopamine. Skin rash as part of an allergic reaction was previously described in subjects who were using levodopa in combination with carbidopa or benserazide; however, etiology was never clear...
February 9, 2018: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/29411702/practical-guidelines-for-perioperative-hypersensitivity-reactions
#3
REVIEW
J J Laguna, J Archilla, I Doña, M Corominas, G Gastaminza, C Mayorga, P Berjes-Gimeno, P Tornero, S Martin, A Planas, E Moreno, M J Torres
Perioperative hypersensitivity reactions constitute a first-line problem for anesthesiologists and allergists, so it is advisable that hospitals have a consensus protocol for the diagnosis and management of these reactions. However, this kind of protocols is not present in many hospitals, leading to problems in treatment, the communication of incidents and subsequent etiological diagnosis. In this document we present a systematic review of the available scientific evidence and provide general guidelines for the management of acute episodes and for referral of patients with perioperative hypersensitivity reactions to Allergy Units...
February 7, 2018: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/29408496/steroid-allergy-clinical-features-and-the-importance-of-excipient-testing-in-a-diagnostic-algorithm
#4
Philip H Li, Annette Wagner, Iason Thomas, Timothy J Watts, Ryszard Rutkowski, Krzysztof Rutkowski
BACKGROUND: True corticosteroid (CS) allergy is rare. Instead, many patients may be allergic to excipients found in various CS preparations. Excipient testing is frequently overlooked. It might lead to unnecessary CS avoidance or dangerous re-exposure. OBJECTIVE: To evaluate the clinical characteristics and frequency of excipient allergy in patients with confirmed type I hypersensitivity to systemic CS preparations. METHODS: Patients with a confirmed diagnosis of allergy (positive skin test or drug provocation test (DPT)) or tolerance (negative DPT to CS) over the past 10 years were studied...
January 30, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29405076/tools-to-investigate-and-avoid-drug-hypersensitivity-in-drug-development
#5
Emanuela Corsini, Manuela Casula, Elena Tragni, Valentina Galbiati, Marc Pallardy
Drug hypersensitivity reactions (DHRs) are common adverse effects of pharmaceuticals that clinically resemble allergies, and which are becoming an important burden to healthcare systems. Alongside accurate diagnostic techniques, tools which can predict potential drug-inducing hypersensitivity reactions in the pre-clinical phase are critical. Despite the important adverse reactions linked to immune-mediated hypersensitivity, at present, there are no validated or required in vivo or in vitro methods to screen the sensitizing potential of drugs and their metabolites in the pre-clinical phase...
February 6, 2018: Expert Opinion on Drug Discovery
https://www.readbyqxmd.com/read/29397373/the-journal-of-allergy-and-clinical-immunology-in%C3%A2-practice-2017-year-in-review
#6
REVIEW
Michael Schatz, Scott H Sicherer, Robert S Zeiger
An impressive number of clinically impactful studies and reviews were published in The Journal of Allergy and Clinical Immunology: In Practice in 2017. As a service to our readers, the editors provide this Year in Review article to highlight and contextualize the advances published over the past year. We include information from articles on asthma, allergic rhinitis, rhinosinusitis, immunotherapy, atopic dermatitis, contact dermatitis, food allergy, anaphylaxis, drug hypersensitivity, urticarial/angioedema, eosinophilic disorders, and immunodeficiency...
January 31, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29393216/establishing-a-safe-administration-of-asa-in-cardiovascular-patients-with-nonsteroidal-anti-inflammatory-drug-hypersensitivity-with-skin-and-or-respiratory-involvement
#7
Mona Al-Ahmad, Tito Rodriguez-Bouza, Midhat Nurkic
BACKGROUND: A history of nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity with cross-intolerance to several drugs is common in some patients with coronary artery disease. We present a series of patients with acute coronary syndrome undergoing ASA desensitization prior to a possible stent to evaluate the short- and long-term efficacy and safety. The aim was to evaluate the outcomes of an ASA desensitization protocol developed by our center based on the guidelines proposed by the EAACI drug allergy expert recommendations...
January 26, 2018: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/29384109/local-anesthetics-allergy-who-should-be-tested
#8
I YIlmaz, S K Özdemir, Ö Aydin, G E Çelik
Objective. To document the test results of patients referred to our clinic for testing with local anesthetics (LAs) in real life conditions and provide data related to the necessity of these tests. Methods. All consecutive subjects who were referred to be evaluated for LA allergy during a two-year follow up were included in the analysis. All subjects underwent skin prick / intradermal tests followed by a subcutaneous provocation test with the LAs tested. Results. A total of 228 subjects were included. The main referral reason was the presence of a history of drug hypersensitivity reaction (DHR) to drugs other than LAs (n = 128; 56%), whereas a history of LA allergy constituted the second most common referral reason (n = 64, 28...
November 22, 2017: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29371073/skin-testing-for-suspected-iodinated-contrast-media-hypersensitivity
#9
Rik Schrijvers, Christine Breynaert, Yazid Ahmedali, Jean-Luc Bourrain, Pascal Demoly, Anca Mirela Chiriac
BACKGROUND: The management of iodinated contrast medium (ICM) hypersensitivity has been a matter of debate. Skin testing to identify a subgroup of ICM allergic patients has been proposed, in addition to complete avoidance, provocation testing, or premedication. OBJECTIVE: The objective of this study was to assess the negative predictive value (NPV) of skin testing for ICM. METHODS: Patients with a hypersensitivity reaction to ICM who underwent skin testing during a 13...
January 19, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29339127/the-basophil-activation-test-can-be-of-value-for-diagnosing-immediate-allergic-reactions-to%C3%A2-omeprazole
#10
Jose J Laguna, Gador Bogas, Maria Salas, Cristobalina Mayorga, Javier Dionicio, Rosario Gonzalez-Mendiola, Adriana Ariza, Ruben Fernández-Santamaría, Isabel Olazabal, Inmaculada Doña, Tahia D Fernandez, Maria J Torres
BACKGROUND: Proton pump inhibitors (PPIs) are commonly used to treat gastrointestinal diseases. Incidence of hypersensitivity reactions to PPIs has risen, likely because of increased consumption. Their diagnosis is difficult, with skin tests (STs) presenting low sensitivity, making it necessary to perform drug provocation tests (DPTs). The value of in vitro tests for the diagnosis of immediate reaction to PPI is unclear. OBJECTIVE: To analyze the diagnostic value of the basophil activation test (BAT) in a group of patients diagnosed with immediate allergy to omeprazole...
January 12, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29274317/saikosaponin-a-inhibits-compound-48-80-induced-pseudo-allergy-via-the-mrgprx2-pathway-in-vitro-and-in-vivo
#11
Nan Wang, Delu Che, Tao Zhang, Rui Liu, Jiao Cao, Jue Wang, Tingting Zhao, Pengyu Ma, Xinzhong Dong, Langchong He
Pseudo-allergic reactions-adverse, non-immunologic, anaphylaxis-like sudden onset reactions mediated through an IgE-independent pathway-are activated by various basic compounds and occur at least as frequently as IgE-mediated reactions to drugs. A large family of G protein coupled receptors (Mas-related genes; Mrgprs) is closely related to pseudo-allergies. However, few therapies can directly target pseudo-allergies and related Mrgprs. Saikosaponin A (SSA) is effective in the treatment of passive cutaneous anaphylaxis (PCA), adjuvant arthritis, and delayed hypersensitiveness...
February 2018: Biochemical Pharmacology
https://www.readbyqxmd.com/read/29186246/severe-cutaneous-adverse-drug-reactions-of-chinese-inpatients-a-meta-analysis
#12
Qiancheng Deng, Xia Fang, Qinghai Zeng, Jianyun Lu, Chen Jing, Jinhua Huang
BACKGROUND: The rate of severe cutaneous adverse drug reactions is low, and these reactions can result in death or disability. An evidence-based epidemiological study of severe cutaneous adverse drug reactions in China has not been reported. OBJECTIVE: The aim of this study was to analyze epidemiology and characteristics of severe cutaneous adverse drug reactions of Chinese inpatients during the recent 15 years with meta-analysis. METHODS: We retrospectively reviewed Chinese literature reporting severe cutaneous adverse drug reactions and collecting data from 2000 to 2015, which were in accordance with our inclusion criteria...
May 2017: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/29175371/natural-history-of-benign-nonimmediate-allergy-to-beta-lactams-in-children-a-prospective-study-in-retreated-patients-after-a-positive-and-a-negative-provocation-test
#13
Aude Tonson la Tour, Marine Michelet, Philippe A Eigenmann, Jean-Christoph Caubet
BACKGROUND: The drug provocation test (DPT) is considered as the gold standard to diagnose drug allergy and is particularly important in the diagnosis of nonimmediate beta-lactam (BL) allergy in children. The natural history of BL allergy remains unknown. OBJECTIVE: Our main aim was to evaluate the natural history of nonimmediate BL hypersensitivity and the long-term tolerance acquisition, and our secondary objective was to determine the negative predictive value (NPV) of the DPT following a 2-day protocol...
November 23, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29163536/drug-hypersensitivity-and-anaphylaxis-in-cancer-and-chronic-inflammatory-diseases-the-role-of-desensitizations
#14
REVIEW
Mariana Castells
Drug allergy is a rising problem in the twenty-first century which affects all populations and races, children, and adults, and for which the recognition, diagnosis, management, and treatment is still not well standardized. Classical and new chemotherapy drugs, monoclonal antibodies (MoAbs), and small molecules to treat cancer and chronic inflammatory diseases are aimed at improving quality of life and life expectancy of patients, but an increasing number of reactions including anaphylaxis precludes their use in targeted populations...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29163180/risk-factors-of-hypersensitivity-to-carboplatin-in-patients-with-gynecologic-malignancies
#15
Yu-Hsiao Tai, Yi-Jou Tai, Heng-Cheng Hsu, Shu-Ping Lee, Yun-Yuan Chen, Ying-Cheng Chiang, Yu-Li Chen, Chi-An Chen, Wen-Fang Cheng
We evaluated the prevalence of and risk factors for hypersensitivity reactions related to carboplatin, which is commonly used to treat gynecological malignancies. All women with pathologically documented ovarian, fallopian tube, or primary peritoneal cancer treated with carboplatin alone or a carboplatin-based combination chemotherapy regimen at a single hospital between January 2006 and December 2013 were retrospectively recruited. We analyzed the incidence, characteristics, risk factors, management, and outcomes of carboplatin-related hypersensitivity reactions among these patients...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29122155/rituximab-hypersensitivity-evaluation-desensitization-and-potential-mechanisms
#16
Johnson T Wong, Aidan Long
BACKGROUND: Rituximab (Rituxan) hypersensitivity (RITS) can be severe and limits the ability to further administer the treatment. Understanding its pattern and desensitization may permit administration in difficult cases. OBJECTIVE: Analyze RITS patient characteristics, hypersensitivity pattern, and desensitization outcomes to optimize management. METHODS: Twenty-five patients with RITS were referred to the Allergy/Immunology Unit at Massachusetts General Hospital over 5 1/2 years...
November 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29105793/what-can-we-learn-in-drug-allergy-management-from-world-health-organization-s-international-classifications
#17
REVIEW
Luciana Kase Tanno, Maria Jose Torres, Mariana Castells, Pascal Demoly
Drug hypersensitivity reactions (DHRs) represent growing health problem worldwide, affecting more than 7% of the general population and represent an important public health problem. However, knowledge in DHRs morbidity and mortality epidemiological data is still not optimal and international comparable standards remain poorly accessed. Institutional databases worldwide increasingly use the WHO International Classification of Diseases (ICD) system to classify diagnoses, health services utilization and death data...
November 6, 2017: Allergy
https://www.readbyqxmd.com/read/29047169/non-immediate-reading-skin-tests-and-prolonged-challenges-in-non-immediate-hypersensitivity-to-beta-lactams-in-children
#18
G Lezmi, F Alrowaishdi, A Bados-Albiero, P Scheinmann, J de Blic, C Ponvert
BACKGROUND: A minority of children reporting non-immediate reactions to beta-lactams (BLs) are allergic. Allergy workup usually includes late-reading (48-72h) skin tests (ST) and short (1-3 days) drug provocation tests (DPT), regardless of the chronology of the index reaction. The sensitivity of hyper-late-reading (≥ 6-7 days) ST and of prolonged DPT for the diagnosis of non-immediate hypersensitiviy to BLs are yet to be determined. OBJECTIVES: To establish the diagnostic values of late- and hyper-late-reading ST and of prolonged DPT in children reporting non-immediate reactions to BLs...
October 19, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/29037819/drug-induced-paradoxical-vocal-fold-motion
#19
Marlene Garcia-Neuer, Donna Marie Lynch, Kathleen Marquis, Jayme Dowdall, Mariana Castells, David Edward Sloane
Vocal cord dysfunction, also known as paradoxical vocal fold motion (PVFM), is a disorder characterized by abnormal vocal cord adduction during inspiration. PVFM is commonly misdiagnosed as asthma because of the similarity of symptoms: cough, wheezing, chest pain, and dyspnea. We present the clinical vignette of a 36-year-old woman with juvenile rheumatoid arthritis and multiple adverse drug reactions who presented with recurrent episodes of unrecognized PVFM during skin testing for drug allergy, omalizumab treatment, and tocilizumab desensitization...
October 13, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29017833/cross-reactivity-in-%C3%AE-lactam-allergy
#20
Robert J Zagursky, Michael E Pichichero
β-Lactam drugs (penicillins, amoxicillin, and cephalosporins) account for 42.6% of all severe drug-induced anaphylaxis. In this review, we focus on clinically significant immunologic cross-reactivity in patients with confirmed penicillin allergy to cephalosporins, and the structural involvement of the R1 and R2 chemical side chains of the cephalosporins causing IgE-mediated cross-reactivity with penicillin and other cephalosporins. Skin tests predict IgE-mediated reactions and showed cross-reactivity between penicillins and early generation cephalosporins that shared side chains, but confirmatory challenge data are lacking...
October 7, 2017: Journal of Allergy and Clinical Immunology in Practice
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