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Allergy drug hypersensitivity

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https://www.readbyqxmd.com/read/28211343/immediate-reactions-to-more-than-1-nsaid-must-not-be-considered-cross-hypersensitivity-unless-tolerance-to-asa-is-verified
#1
D Pérez-Alzate, J A Cornejo-García, N Pérez-Sánchez, I Andreu, A García-Moral, J A Agúndez, J Bartra, I Doña, M J Torres, M Blanca, N Blanca-López, G Canto
BACKGROUND AND OBJECTIVES: Individuals who develop drug hypersensitivity reactions (DHRs) to chemically unrelated nonsteroidal anti-inflammatory drugs (NSAIDs) are considered cross-hypersensitive. The hallmark for this classification is that the patient presents a reaction after intake of or challenge with acetylsalicylic acid (ASA). Whether patients react to 2 or more NSAIDs while tolerating ASA remains to be studied (selective reactions, SRs). Objective: To identify patients with SRs to 2 or more NSAIDs including strong COX-1 inhibitors...
2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/28194756/chlorhexidine-allergy-in-4-specialist-allergy-centres-in-the-uk-2009-2013-clinical-features-and-diagnostic-tests
#2
William Egner, Matthew Helbert, Ravishankar Sargur, Kirsty Swallow, Nigel Harper, Tomaz Garcez, Sinisa Savic, Louise Savic, Eren Effren
We describe an observational survey of diagnostic pathways in 104 patients attending four specialist allergy clinics in the UK following perioperative hypersensitivity reactions to chlorhexidine reactions. The majority were life threatening. Men undergoing urological or cardiothoracic surgery predominated. Skin prick testing and sIgE testing were the most common tests used for diagnosis. Fifty-three % of diagnoses were made on the basis of a single positive test. Where multiple tests were performed the sensitivity of intradermal, basophil activation and skin prick testing was 68% (50-86%), 50% (10-90%) and 35% (17-55%) respectively...
February 14, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28179249/penicillin-skin-testing-as-an-antimicrobial-stewardship-initiative
#3
Bruce M Jones, Christopher M Bland
PURPOSE: An initiative to determine the effects of penicillin skin testing (PST) from an antimicrobial stewardship perspective is described. SUMMARY: Penicillin allergy is one of the most frequently reported allergies; however, only about 10% of self-reports of penicillin allergy are accurate. Incorrect penicillin allergies are therefore a significant barrier to antimicrobial stewardship, with important clinical and economic implications, including increased antimicrobial resistance, an increased overall cost of care, increased length of stay, and, ultimately, increased mortality...
February 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28164269/anaesthetic-hypersensitivity-reactions-in-france-between-2011-and-2012-the-10th-gerap-epidemiologic-survey
#4
C Tacquard, O Collange, P Gomis, J-M Malinovsky, N Petitpain, P Demoly, S Nicoll, P M Mertes
BACKGROUND: Immediate hypersensitivity reactions during anaesthesia are rare but potentially life-threatening. The epidemiology changes with time and evolving professional practice, and hence needs to be monitored. Our objective was to follow this epidemiology. METHODS: This was a retrospective, observational study in French hospital clinics, conducted by GERAP members (Groupe d'Étude des Réactions Anaphylactoïdes Périopératoires). Consecutive patients seen in allergo-anaesthesia outpatient clinics, who had experienced a hypersensitivity reaction during anaesthesia between 1 January 2011 and 31 December 2012, were included...
March 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28110055/adverse-and-hypersensitivity-reactions-to-prescription-nonsteroidal-anti-inflammatory-agents-in-a-large-health-care-system
#5
Kimberly G Blumenthal, Kenneth H Lai, Mingshu Huang, Zachary S Wallace, Paige G Wickner, Li Zhou
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most frequently used medications in the United States. NSAID use can be limited by adverse drug reactions (ADRs), including hypersensitivity reactions (HSRs). OBJECTIVE: We aimed to use electronic health record data to determine the incidence and predictors of HSRs to prescription NSAIDs. METHODS: We performed a retrospective cohort study of all adult outpatients in a large health care system prescribed diclofenac, indomethacin, nabumetone, or piroxicam between January 1, 2004, and September 30, 2012...
January 18, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28094039/cisplatin-can-be-safely-administered-to-ovarian-cancer-patients-with-hypersensitivity-to-carboplatin
#6
A Bergamini, C Pisano, M Di Napoli, L Arenare, C Della Pepa, R Tambaro, G Facchini, P Gargiulo, S Rossetti, G Mangili, S Pignata, S C Cecere
OBJECTIVE: Hypersensitivity reactions (HSR) are frequently reported in patients rechallenged with carboplatin for recurrent ovarian cancer (ROC) and represent a critical issue, since discontinuation of the platinum-based therapy could affect prognosis. Several strategies to allow platinum rechallenge have been described, with controversial outcomes. The aim of this study is to illustrate a 10-year experience with cisplatin in patients with a previous HSR to carboplatin or at risk for allergy...
January 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28057759/potent-nlrp3-inflammasome-activation-by-the-hiv-reverse-transcriptase-inhibitor-abacavir
#7
Atiye Toksoy, Helga Sennefelder, Christian Adam, Sonja Hofmann, Axel Trautmann, Matthias Goebeler, Marc Schmidt
There is experimental and clinical evidence that some exanthematous allergic drug hypersensitivity reactions are mediated by drug-specific T cells. We hypothesized that the capacity of certain drugs to directly stimulate the innate immune system may contribute to generate drug-specific T cells. Here we analyzed whether abacavir, an HIV-1 reverse transcriptase inhibitor often inducing severe delayed-type drug hypersensitivity, can trigger innate immune activation that may contribute to its allergic potential...
February 17, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28049210/hypersensitivity-reactions-to-nonsteroidal-anti-inflammatory-drugs-among-adults-clinical-features-and-risk-factors-for-diagnosis-confirmation
#8
Eva Rebelo Gomes, Luísa Geraldes, Ângela Gaspar, Daniela Malheiro, Susana Cadinha, Carmo Abreu, Marta Chambel, Eugénia Almeida, Emília Faria
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDS) are among the most common causes of drug hypersensitivity (HS) reactions. The diagnosis is based on a careful clinical history, and provocation tests are considered the gold standard for diagnosis. Skin tests have some value to study reactions to pyrazolones. Laboratory investigations are mostly used for research purposes. Different phenotypes have been described. OBJECTIVE AND METHODS: Our aim was to describe the most common clinical manifestations of NSAID HS in a large population of adult patients, the drugs involved, the association with previously described risk factors, and the outcome of diagnostic procedures...
2016: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/28034549/basophil-activation-test-is-a-relevant-biomarker-of-the-outcome-of-rapid-desensitization-in-platinum-compounds-allergy
#9
Pedro Giavina-Bianchi, Violeta Régnier Galvão, Matthieu Picard, Joana Caiado, Mariana C Castells
BACKGROUND: Rapid drug desensitization (RDD) has become a cornerstone in the management of immediate drug hypersensitivity reactions (DHRs) to chemotherapeutic agents. Because of the inherent risk of anaphylaxis during RDD, biomarkers to predict patients at risk of developing such severe reactions are needed. The basophil activation test (BAT) has been used in DHRs as a diagnostic tool. OBJECTIVE: We evaluated basophil CD63 and CD203c expression (BAT) as a biomarker to assess the safety and effectiveness of RDD in platinum compounds-allergic patients...
December 26, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27975150/re-exposure-to-low-osmolar-iodinated-contrast-media-in-patients-with-prior-moderate-to-severe-hypersensitivity-reactions-a-multicentre-retrospective-cohort-study
#10
Hye Jung Park, Jung-Won Park, Min-Suk Yang, Mi-Yeong Kim, Sae-Hoon Kim, Gwang Cheon Jang, Young-Hee Nam, Gun-Woo Kim, Sujeong Kim, Hye-Kyung Park, Jae-Woo Jung, Jong-Sook Park, Hye-Ryun Kang
OBJECTIVES: To evaluate the outcomes of re-exposure to low-osmolar iodinated contrast medium (LOCM) in patients with a history of moderate-to-severe hypersensitivity reaction (HSR). METHODS: We retrospectively evaluated a cohort comprising all subjects satisfying the following conditions at 11 centres: (1) experienced a moderate-to-severe HSR to LOCM by December 2014, and (2) underwent contrast-enhanced computed tomography after the initial HSR between January 2014 and December 2014...
December 14, 2016: European Radiology
https://www.readbyqxmd.com/read/27960170/classification-of-drug-hypersensitivity-into-allergic-p-i-and-pseudo-allergic-forms
#11
Werner J Pichler, Oliver Hausmann
Drug hypersensitivity reactions (DHR) are clinically and functionally heterogeneous. Different subclassifications based on timing of symptom appearance or type of immune mechanism have been proposed. Here, we show that the mode of action of drugs leading to immune/inflammatory cell stimulation is a further decisive factor in understanding and managing DHR. Three mechanisms can be delineated: (a) some drugs have or gain the ability to bind covalently to proteins, form new antigens, and thus elicit immune reactions to hapten-carrier complexes (allergic/immune reaction); (b) a substantial part of immune-mediated DHR is due to a typical off-target activity of drugs on immune receptors like HLA and TCR (pharmacological interaction with immune receptors, p-i reactions); such p-i reactions are linked to severe DHR; and (c) symptoms of DHR can also appear if the drug stimulates or inhibits receptors or enzymes of inflammatory cells (pseudo-allergy)...
2016: International Archives of Allergy and Immunology
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
#12
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/27899028/nano-liposome-based-target-toxicity-machine-an-alternative-complementary-approach-in-atopic-diseases
#13
Behzad Mansoori, Ali Mohammadi, Neda Shajari, Sadaf Davudian, Shima Salehi, Behzad Baradaran
Despite using lots of progression in hypersensitivity, it is not yet a cure. Current treatment for allergy focuses on two approaches, including treats only the symptoms of allergy by utilizing drugs and the other is desensitization therapy (immunotherapy), which involves administration of specific allergens. The main obstacle to hypersensitivity permanent treatment is the IgE producing subclass of B-lymphocytes which is the source of IgE- producing in hypersensitive patients. Removal of these lymphocytes causes noticeable reduction in the levels of IgE and allergic responses significantly...
November 29, 2016: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/27889746/distinct-in-vitro-complement-activation-by-various-intravenous-iron-preparations
#14
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...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/27888028/identifying-allergic-drug-reactions-through-placebo-controlled-graded-challenges
#15
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
#16
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/27865769/discrepancies-in-the-diagnosis-and-classification-of-nonsteroidal-anti-inflammatory-drug-hypersensitivity-reactions-in-children
#17
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
#18
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
#19
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...
January 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27857897/interleukin-4-and-interferon-%C3%AE-are-possible-allergic-markers-in-pediatric-patients-with-%C3%AE-lactam-hypersensitivity
#20
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
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