Allergological approach to drug hypersensitivity reactions

Przybilla, Bernhard; Aberer, Werner; Bircher, Andreas J.; Brehler, R.; Brockow, Knut; Fuchs, Thomas; Hertl, Michael; Mockenhaupt, Maja; Pfaar, Oliver; Ring, Johannes; Sachs, B.; Vieluf, D.; Wedi, Bettina; Worm, Margitta; Zuberbier, Torsten

doi:10.1111/j.1610-0387.2007.06656.x

Cited by 24 publications

(10 citation statements)

References 8 publications

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“…Few guidelines and/or consensus documents are available to support medical decision making on all aspects of DHR. These documents vary in scope and methodology: They are national , regional, or international ; concern one specific drug class ; focus specifically on evaluation tools/management ; or are more general . Although there is no doubt that the use of common systematic approaches for the diagnosis and management of DHRs can considerably improve outcomes, worldwide dissemination and implementation remain major challenges.…”

mentioning

confidence: 99%

InternationalConsensus on drug allergy

Demoly

Adkinson

Brockow

et al. 2014

Allergy

859

964

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When drug reactions resembling allergy occur, they are called drug hypersensitivity reactions (DHRs) before showing the evidence of either drug-specific antibodies or T cells. DHRs may be allergic or nonallergic in nature, with drug allergies being immunologically mediated DHRs. These reactions are typically unpredictable. They can be life-threatening, may require or prolong hospitalization, and may necessitate changes in subsequent therapy. Both underdiagnosis (due to under-reporting) and overdiagnosis (due to an overuse of the term 'allergy') are common. A definitive diagnosis of such reactions is required in order to institute adequate treatment options and proper preventive measures. Misclassification based solely on the DHR history without further testing may affect treatment options, result in adverse consequences, and lead to the use of more-expensive or less-effective drugs, in contrast to patients who had undergone a complete drug allergy workup. Several guidelines and/or consensus documents on general or specific drug class-induced DHRs are available to support the medical decision process. The use of standardized systematic approaches for the diagnosis and management of DHRs carries the potential to improve outcomes and should thus be disseminated and implemented. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), formed by the European Academy of Allergy and Clinical Immunology (EAACI), the American Academy of Allergy, Asthma and Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI), and the World Allergy Organization (WAO), has decided to issue an International CONsensus (ICON) on drug allergy. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences and deficiencies of evidence, thus providing a comprehensive reference document for the diagnosis and management of DHRs.Allergy 69 (2014) 420-437

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mentioning

confidence: 99%

InternationalConsensus on drug allergy

Demoly

Adkinson

Brockow

et al. 2014

Allergy

859

964

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“…For that purpose, a detailed history with careful evaluation of the temporal relationship between drug intake and appearance of skin lesion, as well as a thorough physical examination, is fundamental [38]. [42,43,44 ].…”

Section: Diagnosis Of Drug-induced Skin Reactionsmentioning

confidence: 99%

Diagnosis of drug-induced skin reactions

Burbach

Zuberbier

2011

Current Opinion in Allergy &Amp; Clinical Immunology

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“…In der Leitlinie zur Abklärung von Überempfindlichkeitsreak-tionen auf Arzneimittel werden Schwangerschaft und Stillzeit als Kontraindikationen für Tests mit vermuteten Auslösern gesehen -bei anzunehmender "Kreuzreaktivität" auch für Tests mit Ausweichpräparaten. In Einzelfällen (z B. vermutlich Reaktion auf Hilfsstoffe) wird dabei ein Provokationstest zur Identifizierung eines therapeutisch dringlich benötigten Wirkstoffs auch bei Vorliegen von Kontraindikationen als gerechtfertigt angesehen [19]. Auch wenn die entsprechenden Leitlinien -soweit vorhanden -keine explizite Stellung beziehen, so wird man auf weitere Provokationsteste (nasal, inhalativ, oral, parenteral, Stichprovokationen) wegen des Risikos eines Auftretens anaphylaktischer Reaktionen in der Schwangerschaft verzichten.…”

Section: > In Der Awmf-leitlinie Gilt Schwangerschaft Als Kontraindikunclassified

Allergische Erkrankungen bei Schwangeren

Treudler

2010

Hautarzt

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Allergological approach to drug hypersensitivity reactions

Cited by 24 publications

References 8 publications

InternationalConsensus on drug allergy

InternationalConsensus on drug allergy

Diagnosis of drug-induced skin reactions

Allergische Erkrankungen bei Schwangeren

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