Case Report
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SARS-CoV-2 Infection or Drug Allergy? Two Pediatric Cases Presenting with Angioedema

Year 2022, Volume: 22 Issue: 2, 137 - 140, 09.09.2022
https://doi.org/10.26650/jchild.2022.927535

Abstract

Acute urticaria and angioedema are common clinical findings in children. Although the most common etiological factor is acute infection, drug and food allergies may also present with urticaria and angioedema. Although urticaria and angioedema have frequently been seen in severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infections during the pandemic, underlying drug and food allergies should be kept in mind in the differential diagnosis, and a detailed history should be taken from patients. This article presents two pediatric cases where the patients presented with angioedema occurring in the febrile period and had drug allergy concomitant with positive SARS-CoV-2 PCR test result.

Project Number

yoktur

References

  • 1. Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, BallmerWeber B, et al. The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy 2018;73(7):1393-414. google scholar
  • 2. Sabroe RA: Acute urticaria. Immunol Allergy Clin North Am 2014; 34(1):11-21. google scholar
  • 3. Wedi B, Raap U, Wieczorek D, Kapp A. Urticaria and infections. Allergy Asthma Clin Immunol 2009;5(1):10. google scholar
  • 4. Hassan K. Urticaria and angioedema as a prodromal cutaneous manifestation of SARS-CoV-2 (COVID 19) infection. BMJ Case Rep 2020;13(7):e236981 google scholar
  • 5. Morey-Olivé M, Espiau M, Mercadal-Hally M, Lera-Carballo E, García-Patos V. Manifestaciones cutáneas en contexto del brote actual de enfermedad por coronavirus 2019 (Cutaneous manifestations in the current pandemic of coronavirus infection disease (COVID 2019)). An Pediatr (Engl Ed) 2020;92(6):374-5. google scholar
  • 6. Marcdante Karen J, Kliegman Robert M. Urticaria, Angioedema, and Anaphylaxis, Nelson Essentials of Pediatrics, Chapter 81, 328-332 google scholar
  • 7. Giavedoni P, Podlipnik S, Pericàs JM, Fuertes de Vega I, GarcíaHerrera A, Alós L, et al. Skin Manifestations in COVID-19: Prevalence and Relationship with Disease Severity. J Clin Med 2020;9(10):3261. google scholar
  • 8. Abuelgasim E, Dona ACM, Sondh RS, Harky A. Management of urticaria in COVID-19 patients: A systematic review. Dermatol Ther 2021;34(1):e14328. doi: 10.1111/dth.14328. Epub 2020 Oct 9. google scholar
  • 9. Mawhirt SL, Frankel D, Diaz AM. Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers. Curr Allergy Asthma Rep 2020;20(12):75. google scholar
  • 10. Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol 2020;34(5):e212-e213. google scholar
  • 11. Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy 2020;75(7):1730-41. google scholar
  • 12. Zheng Y, Lai W. Dermatology staff participate in fight against Covid-19 in China. J Eur Acad Dermatol Venereol 2020;34(5):e210-e211. google scholar
  • 13. Wu D, Yang XO. TH17 responses in cytokine storm of COVID-19: An emerging target of JAK2 inhibitor Fedratinib. J Microbiol Immunol Infect 2020;53(3):368-370. google scholar
  • 14. Russell B, Moss C, Rigg A, Van Hemelrijck M. COVID-19 and treatment with NSAIDs and corticosteroids: should we be limiting their use in the clinical setting? Ecancermedicalscience. 2020;14:1023. google scholar
  • 15. Sakaida T, Tanimoto I, Matsubara A, Nakamura M, Morita A. Unique skin manifestations of COVID-19: Is drug eruption specific to COVID-19? J Dermatol Sci 2020;99(1):62-4. google scholar
  • 16. Roberts LJ, Morrow JD. Analgesic-antipyretic and antiinflammatory agents and drugs employed in the treatment of gout. In: Hardman JG, Limbird LL, Goodman Gilman A, editors. The pharmacological basis of therapeutics. 10th edition. New York: McGraw-Hill; 2001. p. 687-731. google scholar
  • 17. Dona I, Blanca-Lopez N, Torres MJ, Garcia-Campos J, Garcia-Nunez I, Gomez F et al. Drug hypersensitivity reactions: response patterns, drug involved, and temporal variations in a large series of patients. J Investig Allergol Clin Immunol 2012;22:363-71. google scholar
  • 18. Sanchez-Borges M, Capriles-Behrens E, Caballero-Fonseca F. Hypersensitivity to non-steroidal anti-inflammatory drugs in childhood. Pediatr Allergy Immunol 2004;15:376-80. google scholar
  • 19. Kowalski ML, Asero R, Bavbek S, Blanca M, Blanca-Lopez N, Bochenek G, et al. Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal antiinflammatory drugs. Allergy 2013;68(10):1219-32. google scholar

SARS-CoV-2 Enfeksiyonu mu İlaç Alerjisi mi? Anjioödem ile Gelen İki Pediatrik Olgu Sunumu

Year 2022, Volume: 22 Issue: 2, 137 - 140, 09.09.2022
https://doi.org/10.26650/jchild.2022.927535

Abstract

Akut ürtiker ve anjiyoödem çocuklarda sık görülen klinik bulgulardır. En yaygın etiyolojik faktör akut enfeksiyon olmakla birlikte, ilaç ve gıda alerjileri de ürtiker/anjiyoödem ile ortaya çıkabilir. Ürtiker ve anjiyoödem, bu pandemi döneminde Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) enfeksiyonu sırasında sık görülmekle birlikte, altta yatabilecek ilaç ve besin alerjileri ayırıcı tanıda akılda tutulmalı ve hastalardan ayrıntılı öykü alınmalıdır. Bu yazımızda ateşli dönemde ortaya çıkan anjiyo-ödem nedeniyle başvuran ve SARS-CoV-2 PCR testi pozitif olup ilaç alerjisi tanısı alan iki pediatrik vaka sunulmuştur.

Supporting Institution

yoktur

Project Number

yoktur

Thanks

yoktur

References

  • 1. Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, BallmerWeber B, et al. The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy 2018;73(7):1393-414. google scholar
  • 2. Sabroe RA: Acute urticaria. Immunol Allergy Clin North Am 2014; 34(1):11-21. google scholar
  • 3. Wedi B, Raap U, Wieczorek D, Kapp A. Urticaria and infections. Allergy Asthma Clin Immunol 2009;5(1):10. google scholar
  • 4. Hassan K. Urticaria and angioedema as a prodromal cutaneous manifestation of SARS-CoV-2 (COVID 19) infection. BMJ Case Rep 2020;13(7):e236981 google scholar
  • 5. Morey-Olivé M, Espiau M, Mercadal-Hally M, Lera-Carballo E, García-Patos V. Manifestaciones cutáneas en contexto del brote actual de enfermedad por coronavirus 2019 (Cutaneous manifestations in the current pandemic of coronavirus infection disease (COVID 2019)). An Pediatr (Engl Ed) 2020;92(6):374-5. google scholar
  • 6. Marcdante Karen J, Kliegman Robert M. Urticaria, Angioedema, and Anaphylaxis, Nelson Essentials of Pediatrics, Chapter 81, 328-332 google scholar
  • 7. Giavedoni P, Podlipnik S, Pericàs JM, Fuertes de Vega I, GarcíaHerrera A, Alós L, et al. Skin Manifestations in COVID-19: Prevalence and Relationship with Disease Severity. J Clin Med 2020;9(10):3261. google scholar
  • 8. Abuelgasim E, Dona ACM, Sondh RS, Harky A. Management of urticaria in COVID-19 patients: A systematic review. Dermatol Ther 2021;34(1):e14328. doi: 10.1111/dth.14328. Epub 2020 Oct 9. google scholar
  • 9. Mawhirt SL, Frankel D, Diaz AM. Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers. Curr Allergy Asthma Rep 2020;20(12):75. google scholar
  • 10. Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol 2020;34(5):e212-e213. google scholar
  • 11. Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy 2020;75(7):1730-41. google scholar
  • 12. Zheng Y, Lai W. Dermatology staff participate in fight against Covid-19 in China. J Eur Acad Dermatol Venereol 2020;34(5):e210-e211. google scholar
  • 13. Wu D, Yang XO. TH17 responses in cytokine storm of COVID-19: An emerging target of JAK2 inhibitor Fedratinib. J Microbiol Immunol Infect 2020;53(3):368-370. google scholar
  • 14. Russell B, Moss C, Rigg A, Van Hemelrijck M. COVID-19 and treatment with NSAIDs and corticosteroids: should we be limiting their use in the clinical setting? Ecancermedicalscience. 2020;14:1023. google scholar
  • 15. Sakaida T, Tanimoto I, Matsubara A, Nakamura M, Morita A. Unique skin manifestations of COVID-19: Is drug eruption specific to COVID-19? J Dermatol Sci 2020;99(1):62-4. google scholar
  • 16. Roberts LJ, Morrow JD. Analgesic-antipyretic and antiinflammatory agents and drugs employed in the treatment of gout. In: Hardman JG, Limbird LL, Goodman Gilman A, editors. The pharmacological basis of therapeutics. 10th edition. New York: McGraw-Hill; 2001. p. 687-731. google scholar
  • 17. Dona I, Blanca-Lopez N, Torres MJ, Garcia-Campos J, Garcia-Nunez I, Gomez F et al. Drug hypersensitivity reactions: response patterns, drug involved, and temporal variations in a large series of patients. J Investig Allergol Clin Immunol 2012;22:363-71. google scholar
  • 18. Sanchez-Borges M, Capriles-Behrens E, Caballero-Fonseca F. Hypersensitivity to non-steroidal anti-inflammatory drugs in childhood. Pediatr Allergy Immunol 2004;15:376-80. google scholar
  • 19. Kowalski ML, Asero R, Bavbek S, Blanca M, Blanca-Lopez N, Bochenek G, et al. Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal antiinflammatory drugs. Allergy 2013;68(10):1219-32. google scholar
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Paediatrics
Journal Section Case Report
Authors

Sevgi Sipahi Çimen 0000-0003-3026-0906

Gizem Adan 0000-0003-2882-4178

Tolga Bacak 0000-0001-6646-3460

Nazan Dalgic 0000-0002-6516-8897

Project Number yoktur
Publication Date September 9, 2022
Published in Issue Year 2022 Volume: 22 Issue: 2

Cite

APA Sipahi Çimen, S., Adan, G., Bacak, T., Dalgic, N. (2022). SARS-CoV-2 Enfeksiyonu mu İlaç Alerjisi mi? Anjioödem ile Gelen İki Pediatrik Olgu Sunumu. Journal of Child, 22(2), 137-140. https://doi.org/10.26650/jchild.2022.927535
AMA Sipahi Çimen S, Adan G, Bacak T, Dalgic N. SARS-CoV-2 Enfeksiyonu mu İlaç Alerjisi mi? Anjioödem ile Gelen İki Pediatrik Olgu Sunumu. Journal of Child. September 2022;22(2):137-140. doi:10.26650/jchild.2022.927535
Chicago Sipahi Çimen, Sevgi, Gizem Adan, Tolga Bacak, and Nazan Dalgic. “SARS-CoV-2 Enfeksiyonu Mu İlaç Alerjisi Mi? Anjioödem Ile Gelen İki Pediatrik Olgu Sunumu”. Journal of Child 22, no. 2 (September 2022): 137-40. https://doi.org/10.26650/jchild.2022.927535.
EndNote Sipahi Çimen S, Adan G, Bacak T, Dalgic N (September 1, 2022) SARS-CoV-2 Enfeksiyonu mu İlaç Alerjisi mi? Anjioödem ile Gelen İki Pediatrik Olgu Sunumu. Journal of Child 22 2 137–140.
IEEE S. Sipahi Çimen, G. Adan, T. Bacak, and N. Dalgic, “SARS-CoV-2 Enfeksiyonu mu İlaç Alerjisi mi? Anjioödem ile Gelen İki Pediatrik Olgu Sunumu”, Journal of Child, vol. 22, no. 2, pp. 137–140, 2022, doi: 10.26650/jchild.2022.927535.
ISNAD Sipahi Çimen, Sevgi et al. “SARS-CoV-2 Enfeksiyonu Mu İlaç Alerjisi Mi? Anjioödem Ile Gelen İki Pediatrik Olgu Sunumu”. Journal of Child 22/2 (September 2022), 137-140. https://doi.org/10.26650/jchild.2022.927535.
JAMA Sipahi Çimen S, Adan G, Bacak T, Dalgic N. SARS-CoV-2 Enfeksiyonu mu İlaç Alerjisi mi? Anjioödem ile Gelen İki Pediatrik Olgu Sunumu. Journal of Child. 2022;22:137–140.
MLA Sipahi Çimen, Sevgi et al. “SARS-CoV-2 Enfeksiyonu Mu İlaç Alerjisi Mi? Anjioödem Ile Gelen İki Pediatrik Olgu Sunumu”. Journal of Child, vol. 22, no. 2, 2022, pp. 137-40, doi:10.26650/jchild.2022.927535.
Vancouver Sipahi Çimen S, Adan G, Bacak T, Dalgic N. SARS-CoV-2 Enfeksiyonu mu İlaç Alerjisi mi? Anjioödem ile Gelen İki Pediatrik Olgu Sunumu. Journal of Child. 2022;22(2):137-40.