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Tackling the Patient with Multiple Drug "Allergies": Multiple Drug Intolerance Syndrome
Autumn Guyer1, Melissa Iammatteo2, Merhunisa Karagic3
1Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California San Francisco, San Francisco, Calif.
The Journal of Allergy and Clinical Immunology. in Practice
|October 11, 2020
Summary
Many older adults are wrongly labeled with drug allergies, impacting care. This study proposes standard terms for diagnosing multiple drug intolerance syndrome and hypersensitivity to improve patient treatment.
Area of Science:
- Clinical Immunology
- Pharmacology
- Internal Medicine
Background:
- Increasingly, aging populations report numerous drug "allergies", often inaccurately.
- This leads to unnecessary medication avoidance, suboptimal care, and increased morbidity.
- Specialist evaluation is crucial for patients with multiple reported drug allergies.
Purpose of the Study:
- To propose standard terminology for evaluating patients with multiple drug allergy labels.
- To clarify the diagnosis of multiple drug intolerance syndrome (MDIS) and multiple drug hypersensitivity syndrome (MDHS).
- To guide accurate "allergy" delabeling in electronic health records.
Main Methods:
- Review of epidemiology and key features of MDIS and MDHS.
- Summary of diagnostic workup methodologies for MDIS.
- Outline of practical management strategies for individuals with MDIS.
Main Results:
- Proposed standard terminology for evaluating multiple drug "allergy" labels.
- Distinction between the more common MDIS and the rarer MDHS.
- Framework for diagnostic workup and management of MDIS.
Conclusions:
- Accurate diagnosis and "allergy" delabeling are essential for optimizing patient care.
- Standardized terminology aids in differentiating intolerance from hypersensitivity.
- Improved management of MDIS can prevent unnecessary medication restrictions.
Keywords:
Drug allergyDrug challengeDrug hypersensitivityDrug intoleranceMultiple drug hypersensitivity syndromeMultiple drug intolerance syndromeMore Related Videos
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