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Drug Toxicity: Allergic Reactions

Drug Toxicity: Allergic Reactions

Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...

Hypersensitivity Reactions: Delayed Hypersensitivity Reactions

Hypersensitivity Reactions: Delayed Hypersensitivity Reactions

Delayed-Type Hypersensitivity (DTH), or Type IV hypersensitivity, is a cell-mediated immune response. It occurs when T cells, rather than antibodies, mediate a reaction to specific antigens. It is characterized by a delayed onset (1-2 days) and involves the recruitment of macrophages to the inflammation site.The initiation of a DTH response begins with the sensitization of T cells. During this phase, which lasts at least 1-2 weeks, antigen-specific T cells are activated, clonally expanded, and...

Allergic Drug Reactions

Allergic Drug Reactions

Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...

Desensitization and Tachyphylaxis

Desensitization and Tachyphylaxis

Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.

Drug toxicity: Idiosyncratic Reactions

Drug toxicity: Idiosyncratic Reactions

Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...

Hypersensitivity Reactions: Immune-Complex Reactions

Hypersensitivity Reactions: Immune-Complex Reactions

Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum...

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Updated: Mar 18, 2026

Induction and Monitoring of Active Delayed Type Hypersensitivity DTH in Rats

Induction and Monitoring of Active Delayed Type Hypersensitivity DTH in Rats

Published on: July 19, 2007

Relapsing drug-induced hypersensitivity syndrome.

Sze-Chin Tan¹, Grace Y L Chan

¹Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.

Current Opinion in Allergy and Clinical Immunology

|July 1, 2016

Summary

Relapses in Drug-Induced Hypersensitivity Syndrome (DIHS) can occur after drug cessation, often linked to human herpesvirus 6 reactivation. Other causes include drug cosensitization and multiple drug allergies, requiring further research.

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Last Updated: Mar 18, 2026

Induction and Monitoring of Active Delayed Type Hypersensitivity DTH in Rats

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Published on: July 19, 2007

Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis

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Published on: December 15, 2011

Induction and Monitoring of Adoptive Delayed-Type Hypersensitivity in Rats

Induction and Monitoring of Adoptive Delayed-Type Hypersensitivity in Rats

Published on: October 1, 2007

Area of Science:

Pharmacology
Immunology
Infectious Diseases

Background:

Drug-Induced Hypersensitivity Syndrome (DIHS) is a severe adverse drug reaction with significant morbidity and mortality.
Relapses, or 'flare-ups', are a rare but critical feature of DIHS, potentially occurring weeks after drug discontinuation.

Purpose of the Study:

To review the pathogenesis of DIHS, focusing on the role of human herpesvirus 6 reactivation.
To describe published case reports of patients experiencing relapsing DIHS.

Main Methods:

Review of existing literature on DIHS pathogenesis.
Analysis of case reports detailing relapsing DIHS and associated factors.

Main Results:

Commonly implicated drugs include antiepileptics, antituberculous drugs, sulfasalazine, allopurinol, and antivirals.
Human herpesvirus 6 reactivation is a primary suspected cause of DIHS relapses.
Drug cosensitization and development of multiple drug allergies are emerging pathomechanisms for DIHS relapse.

Conclusions:

Further research is essential to elucidate the pathogenesis of drug cosensitization and multiple drug allergies in DIHS.
Understanding the role of genetics, identifying risk factors, and developing relapse prevention strategies are critical areas for future investigation.