Drug Allergy

Abstract

Abstract

Drug reactions (DR) are adverse admissions or harmful effects of drugs. They constitute 6.5% of all hospital admission. DR develops with a rate of 15% in patients whoare treated by hospitalization. The possibility of DR should be considered in the differential diagnosis when any medical problem occurs in a person who uses medication. The diagnosis of DHR remains largely clinical. Although diagnostic tests arelimited, they are beneficial according to the effective immune mechanism and presence of organ-specific or systemic findings. Proper identification of a DH upholdsthe principle of primum non nocere. In this article, the apporach to drug allergies in children will be evaluated in accordance with current guidelines.

Keywords

• Child,drug allergy,diagnosis,treatment,approach

İlaç Alerjisi

Öz

Öz

İlaç reaksiyonları (İR) ilaçların istenmeyen ya da zararlı olabilen etkileridir. Tüm hastane başvurularının % 6,5’ini oluşturur. Hastaneye yatırılarak tedavi uygulanan hastalarda ise %15 oranında İR gelişmektedir. İlaç kullanan bir kişide herhangi bir tıbbi sorun geliştiğinde ayırıcı tanıda İR olasılığı düşünülmelidir. Tanıda klinik değerlendirme önemlidir. Tanı testleri sınırlı olmakla birlikte etkili immün mekanizmaya ve organa özgül ya da sistemik bulguların varlığına göre tanısal testlerden yararlanılır. Tanısal değerlendirmeler yapılırken “önce, zarar verme” ilkesi akılda tutulmalıdır. Bu yazıda çocuklarda ilaç alerjilerine yaklaşım güncel rehberler doğrultusunda değerlendirilecektir.

Anahtar Kelimeler

• Çocuk,ilaç alerjisi,tanı,tedavi,yaklaşım

References

1. Kaynaklar 1.Mirakian R, Ewan PW, Durham SR, et al. BSACI guidelines for themanagement of drug allergy. Clin Exp Allergy 2009; 39: 43-61. 2.Schnyder B. Approach to the patient with drug allergy. Immu¬nolAllergy Clin North Am 2009; 29: 405-18. 3.Edwards IR, Aronson JK. Adverse drug reactions: definitions, clas-sification, diagnosis, management, surveillance. Lancet 2000; 356:1255-60. 4.Çelik G, Pichler WJ, Adkinson NF. Drug Allergy. In: Adkinson NF,Bochner BS, Busse WW, (eds). Allergy principles and practice. 7thed. Philadelphia: Mosby-Elsevier Inc; 2009: 1205-26. 5.Joint Task Force on Practice Parameters; American Academy ofAllergy, Asthma and Immunology; American College of Allergy,Asthma and Immunology; Joint Council of Allergy, Asthma andImmunology. Drug allergy: an updated practice parameter. AnnAllergy Asthma Immunol 2010; 105: 259-73. 6.Solensky R, Mendelson LM. Drug Allergy. In: Leung DYM, Samp-son HA, Geha R, (eds). Pediatric allergy: principles and prac-tice. 2nd ed. Saunders: China; 2010: 616-30. 7.Yazıcıoğlu M. Çocukluk çağında ilaç alerjilerine yaklaşım. TürkPed Arş 2014; 49: 99-103 8.http://www.uptodate.com/contents/drug-allergy-classification-and-clinical-features 9.Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM,Greenberger PA, Khan DA, Lang DM, Park HS, Pichler W, Sanc-hez-Borges M, Shiohara T, Thong BY.International Consensuson drug allergy. Allergy 2014;69(4):420-37. 10.Chiriac AM, Demoly P. Drug Allergy Diagnosis. Immunol AllergyClin North Am 2014; 34(3): 461-71. 11.Cantani A. Pediatric allergy, asthma and immunology. Berlin:Springer- Verlag, 2008: 1147-203. 12.Rubio M, Bousquet PJ, Gomes E, et al. Results of drug hypersen-sitivity evaluations in a large group of children and adults. ClinExp Allergy 2012;42(1):123–30. 13.Asero R. Intolerance to nonsteroidal anti-inflammatory drugs mightprecede by years the onset of chronic urticaria. J Allergy Clin Im-munol 2003;111(5):1095–8. 14.Kowalski ML, Makowska JS, Blanca M, et al. Hypersensitivityto nonsteroidal anti-inflammatory drugs (NSAIDs) -classificati-on, diagnosis and management: review of the EAACI/ENDA andGA2LEN/HANNA. Allergy 2011; 66: 818-29. 15.Setkowicz M, Mastalerz L, Podolec-Rubis M, et al. Clinical co-urse and urinary eicosanoids in patients with aspirin-induced ur-ticaria followed up for 4 years. J Allergy Clin Immunol2009;123(1):174–8. 16.Demoly P, Kropf R, Bircher A, et al. Drug hypersensitivity: ques-tionnaire. EAACI interest group on drug hypersensitivity. Allergy1999;54(9):999–1003. 17.Benahmed S, Picot MC, Dumas F, et al. Accuracy of a pharma-covigilance algorithm in diagnosing drug hypersensitivity reac-tions. Arch Intern Med 2005; 165(13):1500–5. 18.Demoly P, Bousquet J. Drug allergy diagnosis work up. Allergy2002; 172: 37-40. 19.Aberer W, Bircher A, Romano A, et al. Drug provocation testingin the diagnosis of drug hypersensitivity reactions: general con¬si-derations. Allergy 2003; 58: 854-63. 20.Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P.General considerations for skin test procedures in the diagno-sis of drug hypersensitivity. Allergy 2002; 57: 45-51. 21.Torres MJ, Gomez F, Dona I, et al. Diagnostic evaluation of pa-tients with nonimmediate cutaneous hypersensitivity reactions toiodinated contrast media. Allergy 2012;67(7):929–35. 22.Hjortlund J, Mortz CG, Skov PS, et al. One-week oral challen-ge with penicillin in diagnosis of penicillin allergy. Acta DermVenereol 2012;92(3):307–12. 23.Lieberman P, Nicklas RA, Oppenheimer J, et al. The diagnosisand management of anaphylaxis practice parameter: 2010 up-date. J Allergy Clin Immunol 2010; 126: 477-80. 24.Brockow K, Aberer W, Atanaskovic-Markovic M, Bavbek S, et al.Drug allergy passport and other documentation for patients withdrug hypersensitivity - An ENDA/EAACI Drug Allergy InterestGroup Position Paper. Allergy 2016;71(11):1533-1539.