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Sulfonamide Hypersensitivity.

Timothy G Chow1, David A Khan2

  • 1Division of Allergy and Immunology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA. timothy.chow@utsouthwestern.edu.

Clinical Reviews in Allergy & Immunology
|July 2, 2021
PubMed
Summary
This summary is machine-generated.

Sulfonamide hypersensitivity reactions, ranging from mild rashes to severe conditions like Stevens Johnson syndrome, are common. Drug challenges are crucial for diagnosis, with desensitization protocols showing limited success.

Keywords:
AllergyDesensitizationHypersensitivitySevere cutaneous adverse reactionSulfonamideTrimethoprim-sulfamethoxazole

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Area of Science:

  • Clinical Immunology
  • Dermatology
  • Pharmacology

Background:

  • Sulfonamides are frequently associated with hypersensitivity reactions.
  • Reactions vary from delayed cutaneous responses to severe syndromes like Stevens Johnson syndrome.
  • Cross-reactivity is low between antimicrobial and non-antimicrobial sulfonamides due to structural differences.

Purpose of the Study:

  • To review the current understanding of sulfonamide hypersensitivity.
  • To evaluate diagnostic and management strategies for sulfonamide hypersensitivity.

Main Methods:

  • Literature review focusing on sulfonamide hypersensitivity.
  • Analysis of diagnostic methods including skin testing and drug challenges.
  • Evaluation of treatment strategies such as desensitization.

Main Results:

  • Delayed cutaneous reactions are more common than immediate IgE-mediated reactions.
  • Skin and in vitro testing for sulfonamide hypersensitivity have limitations.
  • Drug challenges are important for evaluating both immediate and delayed reactions and are safe regardless of HIV status.
  • Evidence for the success of desensitization protocols is limited.

Conclusions:

  • Drug challenges are a key diagnostic tool for sulfonamide hypersensitivity.
  • Current desensitization protocols for sulfonamide hypersensitivity lack strong evidence of efficacy.