Multiple Drug Hypersensitivity Syndrome in a Large Database
| Autor: | Shuchen Zhang, Quentin Landry, Laetitia Ferrando, Pascal Demoly, Anca-Mirela Chiriac, Jean-Luc Bourrain |
|---|---|
| Přispěvatelé: | CCSD, Accord Elsevier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Tongji Medical College [HUST], Huazhong University of Science and Technology [Wuhan] (HUST), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Drug
MESH: Drug Hypersensitivity Allergy [SDV.SP.MED] Life Sciences [q-bio]/Pharmaceutical sciences/Medication media_common.quotation_subject Provocation test Drug allergy Multiple drug hypersensitivity computer.software_genre [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract 03 medical and health sciences 0302 clinical medicine Allergy Unit MESH: Drug Hypersensitivity Syndrome [SDV.SP.MED]Life Sciences [q-bio]/Pharmaceutical sciences/Medication Antibiotics MESH: Skin Tests Allergy test medicine Immunology and Allergy 030212 general & internal medicine [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology media_common Drug provocation tests MESH: Humans Database business.industry MESH: Retrospective Studies medicine.disease MESH: Databases Factual MESH: Male 3. Good health Drug class 030228 respiratory system Drug Hypersensitivity Syndrome [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie MESH: Hypersensitivity Immediate business Skin tests computer MESH: Female [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology Drug hypersensitivity |
| Zdroj: | Journal of Allergy and Clinical Immunology: In Practice Journal of Allergy and Clinical Immunology: In Practice, Elsevier, 2020, 8 (1), pp.258-266.e1. ⟨10.1016/j.jaip.2019.06.009⟩ |
| ISSN: | 2213-2198 |
| DOI: | 10.1016/j.jaip.2019.06.009⟩ |
| Popis: | International audience; Multiple drug hypersensitivity syndrome (MDHS) is defined as confirmed drug hypersensitivity (DH) to at least 2 chemically and pharmacologically unrelated drugs. Reports of MDHS are scarce and poorly specified, and studies that diagnose MDHS on the basis of positive allergy test results are lacking.Objective: To evaluate retrospectively the frequency and characteristics of patients with MDHS in a large database.Methods: We included all patients who consulted and were tested in our Allergy Unit between September 1996 and February 2018 for a suspicion of DH. Clinical history and allergy workup results compiled in our Drug Allergy and Hypersensitivity Database were reviewed, and data of patients with a diagnosis of MDHS were retrieved and analyzed.Results: During this period a total of 9250 patients were explored and 1819 tested positive for at least 1 drug. Forty-five cases, 30 female and 15 male patients cumulating 92 DHs, were confirmed as having MDHS. An immunologic mechanism, as demonstrated by positive skin testing, accounted for 59 DHs. Drug provocation tests were performed to confirm the diagnosis for the remaining 33 DHs. Of the 92 DHs in this series, 38 were classified as type IV and 21 as type I allergies; 33 remained of undetermined mechanism. Drug class occurrences seem to differ from those in monoallergic patients.Conclusions: Our data support the concept of MDHS as a distinct and rare subgroup of DH. The prevalence in our database was 2.5% in the total DH alleged patient population and 0.5% of the demonstrated DHs. Skin testing and drug provocation tests are mandatory for confirming the diagnosis. |
| Databáze: | OpenAIRE |
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