| Popis: |
U E S D A Y 907 Clinical Presentation and Outcomes Of Children Undergoing Evaluation For Drug Allergy Dara Mairiang, MD, Dr. Wiparat Manuyakorn, MD, Wasu Kamchaisatian, MD, Soamarat Vilaiyuk, MD, Suwat Benjaponpitak, MD; Division of Pediatric Allergy/Immunology/Rheumatology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. RATIONALE: Drug allergy is a major problem encountered among general practitioners and allergists. Patients are frequently overdiagnosed as drug allergywithout proper confirmatory tests. The aim of this studywas to assess the prevalence, clinical presentation and outcomes of children that underwent evaluation for drug allergy. METHODS: Medical records of children suspected drug allergy who underwent evaluation for drug allergy from 2007 to 2013 were reviewed. Children were confirmed allergic by positive skin test and/or drug provocation test (DPT). RESULTS: Sixty children were evaluated for drug allergy. The most common suspected drug was antibiotics (72.3%), followed by acetaminophen (7.7%) and NSAIDs (3%). In the group of antibiotics, B-lactam antibiotic was the most common. The onset of symptom was highly variable (median 4.5 hours; 0.08-168) in which non-immediate onset was the majority. Skin and mucocutaneous reactions were the most common presentation (85.9%) particularly urticaria (50.7%) and maculopapular rash (28.2%). Only 26.6 percent of children were confirmed allergic to offending drugs (20% by skin test and 6.6% by DPT). Twenty three percent of them had positive DPT despite negative skin test. DPT reactions did not correlated with presenting symptoms of drug allergy. There were no differences in age, onset nor primary symptom of drug allergy between confirmed allergy and non-allergic group. History of atopy, autoimmune disease and malignancy were not associated with DPT outcomes. Conclusions : Drug allergy is commonly reported but only a minority of children have true allergy. There were no precise clinical predictors for drug allergy. Thus, DPT remains the gold standard for diagnosis. |
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