Atopy and systemic reactions to drugs

Abstract

To elucidate whether systemic reactions (SR) to drugs should be included in the atopic status in epidemiological studies, we compared the distribution of atopy in subjects with or without a history of SR to drugs. The studied population comprised 2067 adults, 20 to 60 years old, visiting a health care center for a check-up examination. The protocol included a questionnaire related to history of SR to drugs and a Phadiatop test which evaluates on a blood sample the presence of specific IgE against common aeroallergens. Overall, 14.7% of the study group, including 66% women, reported reliable histories of SR to drugs. The cumulative prevalence of asthma, hay fever and childhood dermatitis was higher in the SR group. By contrast, the percentage of positive Phadiatop tests was similar in subjects with or without a history of SR. Thus atopy, defined by an objective criterion, i.e. the presence of specific IgE against common aero-allergens, is not associated with the occurrence of SR to drugs. Such a history should not be included as part of the atopic status.

Drug provocation tests to betalactam antibiotics: experience in a paediatric setting

“…Atopic disease is not generally considered a risk factor for the development of ADRs. 28 However, atopy seems to constitute a significant risk factor in ADR to NSAIDs 29 and more recently seems to be linked to a history of penicillin allergy. 30 Asthma appears to be a risk factor for severe reactions 31 and in Singaporean children with a reported ADR, they were more likely to have a diagnosis of asthma compared to the control group.…”

Identifier et comprendre les allergies médicamenteuses

“…La voie parentérale est la plus immunogène, devant les voies locales (pommades, crèmes, collyres…), égale-ment très immunogènes du fait, probablement, de l'inflammation locale. La plupart des études démontrent que les femmes sont plus souvent atteintes que les hommes (65 %-70 % versus 30 %-35 %) [15]. Il est par ailleurs souvent rapporté que les enfants sont moins concernés par ce type de réactions que les adultes.…”

“…Toutefois, des études systé-matiques bien conduites font encore défaut. Les patients atopiques ne semblent pas prédisposés [15], mais leurs réactions pourraient être plus sévères. Cette notion est cependant régulièrement controversée et l'atopie pourrait jouer un rôle dans le cas de réactions à certains médicaments tels que la chymopapaïne.…”

Allergy to Antibiotics in Children: Who Is to Blame and What to Do?

“…Some experts deem it unreasonable to restrict the use of ABD on the basis of presence of atopic disease only. Most publications featuring this statement quote the trial by E. Haddi et al (1990), who compared frequency of detection of specific IgE to air allergens in patients with anamnestic data of systemic allergic reactions to drugs. The main conclusion of that doubtful work in terms of the applied methods was that atopic disease is not a risk factor of development of systemic allergic reactions to drugs [31].…”

“…Most publications featuring this statement quote the trial by E. Haddi et al (1990), who compared frequency of detection of specific IgE to air allergens in patients with anamnestic data of systemic allergic reactions to drugs. The main conclusion of that doubtful work in terms of the applied methods was that atopic disease is not a risk factor of development of systemic allergic reactions to drugs [31]. This statement has been dramatically reviewed by the "Drug allergy: an updated practice parameter" issued in 2010 by the American Academy of Allergy, Asthma and Immunology, the American College of Allergy, Asthma and Immunology and the Joint Council of Allergy, Asthma and Immunology), which states that atopic disease is a risk factor of development of drug hypersensitivity to drugs in whole and to ABD in particular [30].…”