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Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity
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Multiple Drug Hypersensitivity Syndrome in a Large Database.

Quentin Landry1, Shuchen Zhang2, Laetitia Ferrando1

  • 1Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, University of Montpellier, Montpellier, France.

The Journal of Allergy and Clinical Immunology. in Practice
|June 26, 2019
PubMed
Summary
This summary is machine-generated.

Multiple drug hypersensitivity syndrome (MDHS) is a rare condition confirmed by allergy testing in 0.5% of patients. Diagnosis requires skin and provocation tests for accurate identification of drug hypersensitivity (DH).

Keywords:
AntibioticsDrug hypersensitivityDrug provocation testsMultiple drug hypersensitivitySkin tests

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Area of Science:

  • Allergy and Immunology
  • Clinical Pharmacology

Background:

  • Multiple drug hypersensitivity syndrome (MDHS) is defined as confirmed drug hypersensitivity (DH) to at least two unrelated drugs.
  • Existing reports on MDHS are scarce, poorly specified, and lack diagnostic confirmation through positive allergy testing.

Purpose of the Study:

  • To retrospectively evaluate the frequency and characteristics of patients diagnosed with MDHS.
  • To analyze data from a large allergy unit database to understand MDHS prevalence and patient profiles.

Main Methods:

  • Retrospective review of clinical history and allergy workup results for patients suspected of DH between 1996 and 2018.
  • Inclusion of patients tested in the Allergy Unit, with data retrieval and analysis for confirmed MDHS cases.

Main Results:

  • Out of 9250 patients, 45 (0.5%) were confirmed to have MDHS, involving 92 confirmed drug hypersensitivities (DHs).
  • Immunologic mechanisms confirmed by skin testing accounted for 59 DHs; drug provocation tests confirmed the remaining 33.
  • Allergies were classified as type IV (38), type I (21), with 33 of undetermined mechanism; drug class occurrences differed from monoallergic patients.

Conclusions:

  • MDHS represents a distinct and rare subgroup of DH, with a prevalence of 0.5% among patients with demonstrated DH.
  • Accurate diagnosis of MDHS necessitates confirmation through skin testing and drug provocation tests.