Immediate and delayed hypersensitivity to corticosteroids

Basedow, Sarah; Eigelshoven, Sibylle; Homey, Bernhard

doi:10.1111/j.1610-0387.2011.07718.x

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…These situations are rare but can be seen in high‐risk groups of patients, such as those who receive multiple doses of corticosteroids 279 . Steroid hypersensitivity can be either type I (IgE mediated), which can include anaphylaxis (rare, 0.3%‐0.5%), or, more commonly, type IV (T cell mediated), which usually follows a topical corticosteroid application 280‐282 . Such reactions are usually triggered by preservative or matrix in the steroid preparation rather than the active medication, and a switch to another preparation is often the solution.…”

Section: Guideline Key Action Statementsmentioning

confidence: 99%

Clinical Practice Guideline: Hoarseness (Dysphonia) (Update)

Stachler

Francis

Schwartz

et al. 2018

Otolaryngol.--head neck surg.

240

204

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Objective. This guideline provides evidence-based recommendations on treating patients who present with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life. Dysphonia affects nearly one-third of the population at some point in its life. This guideline applies to all age groups evaluated in a setting where dysphonia would be identified or managed. It is intended for all clinicians who are likely to diagnose and treat patients with dysphonia.Purpose. The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm.For this guideline update, the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of advanced practice nursing, bronchoesophagology, consumer advocacy, family medicine, geriatric medicine, internal medicine, laryngology, neurology, otolaryngology-head and neck surgery, pediatrics, professional voice, pulmonology, and speech-language pathology.Action Statements. The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should assess the patient with dysphonia by history and physical examination to identify factors where expedited laryngeal evaluation is indicated. These include, but are not limited to, recent surgical procedures involving the head, neck, or chest; recent endotracheal intubation; presence of concomitant neck mass; respiratory distress or stridor; history of tobacco abuse; and whether the patient is a professional voice user. (2) Clinicians should advocate voice therapy for patients with dysphonia from a cause amenable to voice therapy.The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as su...

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Section: Guideline Key Action Statementsmentioning

confidence: 99%

Clinical Practice Guideline: Hoarseness (Dysphonia) (Update)

Stachler

Francis

Schwartz

et al. 2018

Otolaryngol.--head neck surg.

240

204

View full text Add to dashboard Cite

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“…Aber auch an eher ungewöhnliche Auslöser muss gedacht werden, zum Beispiel: ▪ Kortikosteroide (häufig zur Vermeidung postoperativer Schwellungen eingesetzt) [69], ▪ das Sterilisationsgas Ethylenoxid [70], ▪ Arzneimittelzusatzstoffe, wie Polyethylenglykol [71] oder Methylzellulose [72], ▪ lokal applizierte Antibiotika [73], die z. B. bei der Implantation von Prothesenmaterialien im Zement Verwendung finden (Differenzialdiagnose zur pulmonalen Embolie durch Zementbestandteile [74]).…”

Section: Sonstigeunclassified

Perioperative Anaphylaxie auf Arzneimittel

Pfützner¹,

Wulf²

2017

Anästhesiol Intensivmed Notfallmed Schmerzther

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The diagnostic evaluation of perioperative anaphylaxia is of great importance for the medical care of the affected persons in the context of renewed interventions in general anesthesia. The most frequent triggers include muscle relaxants, antibiotics, latex and analgesics of the type of the cyclooxygenase inhibitors, but other perioperatively administered drugs such as opioids, anesthetics, benzodiazepines, dyes, disinfectants and even corticosteroids or drug additives may also be the cause in rare cases. The most important aim is therefore the identification of the responsible drug, for which a near-time allergological diagnosis should be carried out within the first 4 weeks to 6 months after the reaction. At the end of the examinations, the patient receives a structured allergy passport, which includes information on the drug reaction, the triggers and alternative medicines, as well as possible preventive measures for future surgical procedures. It should be noted, however, that the latter are not a guarantee that, upon renewed exposure to the causative medicinal product, there will be no, possibly even heavier, anaphylactic reaction.

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“…Idiosyncratic effects, 56 for example, antiepileptic drugs and delayed allergic hypersensitivity reactions 57,58 ; however, the irrelevance of dose for idiosyncratic effects is debatable 59 (d) Cumulative dose in the past X days … the cumulative dose to which a person was exposed within the X days prior to and including day t. In this paper, we set X = 30. (e) Duration of use … the number of days for which a person was exposed prior to and including day t.…”

Section: Simulating Adverse Eventsmentioning

confidence: 99%