Diagnosis and treatment of drug allergy

Patterson, Roy

doi:10.1016/0091-6749(88)90905-0

Cited by 25 publications

(3 citation statements)

References 11 publications

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“…[36] These tests can be administered 4 to 6 weeks after the reaction and are sensitive in detecting β-lactam allergy, [15.16] although most experts do not consider them useful with non-β-lactams. [3] However, there have been occasional reports of skin test positivity in patients with serious immediate hypersensitivity [37][38][39][40] macrolides, [41,42] rifampicin (rifampin), [43] rifamycin, [44] sulfamethoxazole [45] and trimethoprim.…”

Section: Skin Testsmentioning

confidence: 99%

Recognising Antibacterial Hypersensitivity In Children

Romano

2000

Pediatric Drugs

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Adverse reactions to antibacterial agents are not uncommon in children. They are classified as 'immediate' or 'nonimmediate' according to the time interval between drug administration and onset. Immediate reactions occur within 1 hour and are manifested by urticaria and/or angioedema, bronchospasm and anaphylactic shock; immunological reactions are mediated by IgE antibodies. The main nonimmediate reactions (occuring after more than 1 hour) are maculopapular rash, urticaria and serum sickness; T lymphocytes may participate in maculopapular rash. Clinical assessment of such reactions is complex. The patient's history is fundamental; the allergological examination includes in vivo and in vitro tests selected on the basis of the clinical features and the phase of reaction. In the late phase, prick and intradermal tests are sensitive in evaluating beta-lactam allergy. Together with delayed-reading intradermal testing, patch testing seems to be useful in diagnosing maculopapular reactions to systemically administered aminopenicillins. Determination of specific IgE levels is the most common in vitro method for diagnosing immediate reactions. In the acute phase, serum tryptase and urinary N-methylhistamine assays are reliable in diagnosing type I pathogenic mechanisms in immediate reactions. Unfortunately, there are few in vitro tests for evaluating other reactions, and most are not fully validated. In selected cases, provocation tests should be performed.

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Section: Skin Testsmentioning

confidence: 99%

Recognising Antibacterial Hypersensitivity In Children

Romano

2000

Pediatric Drugs

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“…A small molecular weight substance is easily removed by the body, but when the molecular weight of an antigenic substance is more than 4000 Da, there is the capability to cause an allergic reaction. 18,19 In TCMI, proteins are the compounds that most commonly cause adverse sensitive reactions. [20][21][22] Proteomics technology has been widely used in the study of allergic reactions and has become the main method for isolation, identification, and removal of immunogenicity.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Immunogenicity of Acanthopanax senticosus Injection

Feng

Jiang

2020

Natural Product Communications

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The cause of the immunogenicity of Acanthopanax senticosus injection has been studied. The method used for the preparation of the injection includes boiling the plant material in water, precipitation with ethanol, and filtration to produce the extract. In the current study, this extract was treated with saturated ammonium sulfate to collect the protein from the extract. Indicators of systemic allergy, including total immunoglobulin (IgE), interleukin -4 (IL-4), and interferon-gamma (IFN-γ) levels in the antiserum of Guinea pigs sensitized with this protein extract were used to determine the immunogenicity of the protein extract. Testing was performed using Western blotting to identify IgE in antiserum binding in Guinea pigs sensitized by injection. The target protein band was further identified by matrix-assisted laser desorption/ionization-time of flight mass spectrometry. The protein extract from A. senticosus caused positive reactions and significantly increased the levels of total IgE, IL-4, and IFN-γ in the serum of sensitized Guinea pigs. Western blotting showed that a group of proteins with a molecular weight of 60 000 in the A. senticosus protein extract acted as the major immunogenic protein by binding to serum IgE of Guinea pigs sensitized with A. senticosus injection. The protein was a pyruvate kinase homologous protein with high sequence similarity to the pyruvate kinase protein of Vitis vinifera. It was concluded that the allergic reaction caused by the injection of A. senticosus may be related to the interaction of these macromolecular proteins within the body.

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“…Unfortunately, it was not possible to determine the detailed mechanism of reaction in this case. Many drugs and sorts of food are active as the so-called direct histamine release factor causing degranulation of mastocytes and basophilic granulocytes without IgE participation [ 5 ]. It should be added that some sort of drugs can be a reason for a pseudo-allergic reaction as well as allergic and allergic IgE-dependent reactions.…”

Section: Discussionmentioning

confidence: 99%

Angioneurotic edema: a rare case of hypersensitivity to metoclopramide

Pietrzko¹,

Zakrzewski²,

Matuszewski³

et al. 2013

pdia

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The case of a 30-year-old woman who had already experienced two incidents of angioneurotic edema and urticaria caused by drugs during the acute gastroenteritis. The allergological workup revealed hypersensitivity to metoclopramide. This case documents that metoclopramide, a drug commonly used to inhibit the vomiting, may cause not only bronchospastic reaction in an asthmatic patient but also angioneurotic edema of the tongue and larynx as well as urticaria. No similar cases in the literature were found.

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Diagnosis and treatment of drug allergy

Cited by 25 publications

References 11 publications

Recognising Antibacterial Hypersensitivity In Children

Recognising Antibacterial Hypersensitivity In Children

Analysis of Immunogenicity of Acanthopanax senticosus Injection

Angioneurotic edema: a rare case of hypersensitivity to metoclopramide

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