Pediatric Drug Hypersensitivity

Rukasin, Christine; Norton, Allison E.; Broyles, Ana Dioun

doi:10.1007/s11882-019-0841-y

Cited by 12 publications

(13 citation statements)

References 105 publications

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“…It is recommended that we evaluate medication side chains to safely challenge beta lactams with different side chains. 18,36) Finally, a study on the natural history of betalactam DH in children demonstrat ed re sults suggestive of tolerance acquisi tion. 37) Nonsteroidal anti-inflammatory drugs NSAIDs are widely used for pain relief, fever control, and antiinflammation in children.…”

Section: Beta-lactam Antibioticsmentioning

confidence: 99%

“…5,6,14,1720) Cutaneous symptoms include urticaria, angioedema, and for some drugs, such as sulfonamides, fixed drug eruptions. 16,18,21) Gastrointes tinal symptoms included nausea, vomiting, diarrhea, or constipa tion ( Table 2). Isolated respiratory reactions are mostly restricted to NSAIDs but may also present as a part of anaphylaxis.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…16) Sequential SPT and IDT can safely diagnose suspected IgEmediated reactions, but the dia g nostic value in children is evaluated in a limited number of studies. 18,5962) Penicillin and minor determinants are the only com mercial agents for SPT, but even these are not available in Korea, and other skin tests must be prepared according to guide lines. 63) Delayed reading of IDT at 48-72 hours and patch testing can be used to evaluate nonimmediate reactions and SCARs.…”

Section: Skin Testmentioning

confidence: 99%

“…64) However, a negative skin test cannot rule out DH and DPT remains the gold standard in diagnosing DH in children. 18,60,65) Due to the pain and difficulty of IDT in children, experts are leaning toward DPT before IDT, especially in cases of nonimme diate reactions. 16,66)…”

Section: Skin Testmentioning

confidence: 99%

“…73) The different routes of DPT (oral, parenteral, topical, and cutaneous) vary depending on the culprit agent. 18,58) Several protocols were proposed for children, including single, graded, or multipleday challenges, but there is no single standardized protocol. 7376) The recent European Academy of Allergy and Clinical Immunology guideline suggests starting with 1/10 of a single age/weightap propriate dose and proceeding to a half and then a full dose; for patients with severe reactions, the starting dose may be as low as 1:10000 to 1:1000.…”

Section: In Vitro Testmentioning

confidence: 99%

See 4 more Smart Citations

Drug Allergy in Children: What Should We Know?

Park

Suh

2020

Clin Exp Pediatr

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The drug allergy “label” may have a lifetime of consequences for a child. Many children with alleged drug allergies are proven to be tolerant to the culprit medication when challenged. The field of drug hypersensitivity is a recently evolving field of research, but studies on its epidemiology and diagnostic tools are lacking in children. Clinical history is significant in the diagnosis and classification of drug hypersensitivity in children. Diagnostic tools have been evaluated in a limited number of children; therefore, the guidelines are mainly in line with those for adults. Here, we review the clinical characteristics, main drugs, risk factors, and diagnosis of drug hypersensitivity to aid in its accurate diagnosis in children.

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Section: Beta-lactam Antibioticsmentioning

confidence: 99%