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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...
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Hypersensitivity, also known as a hypersensitivity reaction or allergic reaction, is a condition where the body's immune system reacts abnormally to a foreign substance. Such substances, that cause hypersensitivity are referred to as an allergen, could be something typically harmless to most people, like pollen or certain foods.
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Adrenergic agonists have diverse therapeutic uses across various medical conditions and emergencies.
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Drug-Induced Anaphylaxis in Children.

Annamaria Bianchi1, Rocco Valluzzi2, Giuseppe Crisafulli3

  • 1UOC Pediatria, Azienda Ospedaliera San Camillo Forlanini, 00152 Roma, Italy.

Biomedicines
|March 28, 2024
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Summary

Drug-induced anaphylaxis in children, often caused by antibiotics and NSAIDs, requires prompt adrenaline treatment. Management includes allergen avoidance and desensitization for essential drug allergies.

Keywords:
anaphylaxischildrendrugdrug-induced anaphylaxishypersensitivity reaction

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Area of Science:

  • Pediatric Allergy and Immunology
  • Clinical Pharmacology
  • Immunology

Background:

  • Drug-induced anaphylaxis (DIA) is less frequent in children than adults.
  • Beta-lactams and nonsteroidal anti-inflammatory drugs (NSAIDs) are primary culprits.
  • Prevalence varies with age, gender, and atopy.

Purpose of the Study:

  • To review drug-induced anaphylaxis in pediatric populations.
  • To discuss diagnostic approaches and management strategies.
  • To highlight the importance of desensitization protocols.

Main Methods:

  • Review of epidemiological data on DIA prevalence in children.
  • Discussion of pathophysiological mechanisms (IgE-mediated and non-IgE).
  • Analysis of diagnostic tools including clinical criteria, in vitro/in vivo tests, and provocation tests.

Main Results:

  • Key drug classes implicated: antibiotics, NSAIDs, neuromuscular blockers, monoclonal antibodies.
  • Immediate management focuses on adrenaline administration.
  • Long-term strategies involve allergen avoidance and patient education.

Conclusions:

  • DIA in children necessitates a comprehensive diagnostic and management approach.
  • Adrenaline is the cornerstone of acute treatment.
  • Desensitization is vital for children needing essential but allergenic medications, such as antibiotics and chemotherapy agents.