Çocuklarda İlaç Alerjileri

Deniz Özçeker

Çocuklarda İlaç Alerjileri

Öz

Bir ilacın profilaksi, tanı veya tedavi amacı ile kullanımı sırasında veya sonrasında oluşan istenmeyen etkiler ilaç aşırı duyarlılık reaksiyonu (ADR), ilaç ters etkisi veya ilaç reaksiyonu olarak tanımlanır. İlaç ADR yaşamı tehdit edebilecek durumlara neden olabilmesi, hastanede yatış süresini uzatabilmesi, tedavi maliyetini artırabilmesi nedeni ile önemli bir sağlık sorunudur. Tanının en önemli kısmını dikkatli alınan bir anamnez oluşturur. Öncelikle reaksiyonun ilaç alerjisi ile ilişkisi belirlenmeli, sonrasında da bu durumun immünolojik reaksiyon mu yoksa nonimmün reaksiyon mu olduğuna karar verilmelidir. Öyküye göre tanısal testler planlanmalıdır. İlaç alerjilerinin akut tedavisi suçlanan ilacın kesilmesi ve aktif lezyonun durumuna göre gerekli destek medikal tedavi uygulanması şeklindedir. Hastalarda uzun dönemli yaklaşım planı yapmak son derece önemlidir. İlaç alerjisi olan hastalar akılcı ilaç kullanımı konusunda eğitilmelidir. Bu yazıda çocuklarda ilaç alerjilerine yaklaşım güncel rehberler doğrultusunda değerlendirilecektir.

Anahtar Kelimeler

Kaynakça

1. World Health Organization. International drug monitoring: the role of the hospital. Geneva: The Organization, 1966.
2. Mirakian R, Ewan PW, Durham SR, Youlten LJ, Dugué P, Friedmann PS et al. BSACI guidelines for the management of drug allergy. Clin Exp Allergy 2009; 39: 43-61.
3. Lange L, Koningsbruggen SV, Rietschel E. Questionnaire-based survey of lifetime-prevalence and character of allergic drug
reactions in German children. Pediatr Allergy Immunol. 2008 Nov;19(7):634-8.
4. Orhan F, Karakas T, Cakir M, Akkol N, Bahat E, Sonmez FM, et al. Parental-reported drug allergy in 6- to 9-yr-old urban schoolchildren. Pediatr Allergy Immunol. 2008 Feb;19(1):82- 5.
5. Kaya A, Erkoçoğlu M, Civelek E, Çakır B, Kocabaş CN. Prevalence of confirmed IgE-mediated food allergy among adolescents
in Turkey. Pediatr Allergy Immunol. 2013 Aug;24(5):456-62.
6. Kvedariene V, Sitkauskiene B, Tamasauskiene L, Rudzeviciene O ,Kasiulevicius V, Nekrosyte G, et al. Prevalence of selfreported

drug hypersensitivity reactions among Lithuanian children and adults. Allergol Immunopathol (Madr). 2019 Jan - Feb;47(1):32-37.
7. Arikoglu T, Aslan G, Batmaz SB, Eskandari G, Helvaci I, Kuyucu S. Diagnostic evaluation and risk factors for drug allergies
in children: from clinical history to skin and challenge tests. Int J Clin Pharm. 2015 Aug;37(4):583-91.
8. Tan VA, Gerez IF, Van Bever HP. Prevalence of drug allergy in Singaporean children. Singapore Med J. 2009 Dec;50(12):1158-61.
9. Davies DM, Ashton CH, Rao JG, Rawlins MD, Routledge PA, Savage RL et al. Comprehensive clinical drug information service: first year’s experience. Br Med J 1977;1:89–90.
10. Thong BY, Leong KP, Tang CY, Chng HH. Drug allergy in a general hospital: Results of a novel prospective inpatient reporting system. Ann Allergy Asthma Immunol 2003;90:342-7.
11. Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA et al. International consensus on drug allergy. Allergy 2014 Apr;69(4):420-37.
12. Bircher AJ, Scherer Hofmeier K. Drug hypersensitivity reactions: Inconsistency in the use of the classification of immediate
and nonimmediate reactions. J Allergy Clin Immunol 2012;129: 263–64
13. Romano A, Torres MJ, Castells M, Sanz ML, Blanca M. Diagnosis and management of drug hypersensitivity reactions. J Allergy Clin Immunol. 2011 Mar;127:67-73
14. Adkinson NF. Drug Allergy. Adkinson NF, YungingerJW, BusseWW, Bochner BS Holgate ST, Simons FE (eds) Middleton's
Allergy: Principles and Practice 6. baskı Mosby, China, 2003, s: 1679-1694.
15. Pichler WJ. Delayed drug hypersensitivity reactions. Ann Intern Med 2003;139:683–693.
16. Türkiye Ulusal Allerji ve Klinik İmmünoloji Derneği. Çelik G, Dursun B (eds). İlaç aşırı duyarlılık reaksiyonlarına yaklaşım ulusal rehber güncellemesi 2019. Buluş Tasarım, Ankara, 2019.
17. Adkinson NF Jr. Risk factors for drug allergy. J Allergy Clin İmmunol 1984;74:567
18. Demoly P, Viola M, Rebelo Gomes E, Romano A. Epidemiology and causes of drug hypersensitivity. In: Pichler EJ (ed). Drug hypersensitivity, Karger Basel, Switzerland 2007.
19. Celik GE, Pichler WJ, Adkinson NF. Drug allergy. In: Adkinson NF, Bochner BS, Wesley Burks A, Busse WW, Holgate ST,
Lemanske RF, O’Hehir ER (eds). 8th ed. Middleton's Allergy Principles and Practice. Elsevier Saunders. 2014:1274-95.
20. Carr A, Swanson C, Penny R, Cooper DA. Clinical and laboratory markers of hypersensitivity to trimethoprim-sulfamethoxazole
in patients with Pneumocystis carinii pneumonia and AIDS.J Infect Dis. 1993 Jan;167(1):180-5.
21. Gomes ER, Kuyucu S. Epidemiology and risk factors in drug hypersensitivity reactions. Curr Treat Options Allergy 2017;4:239-57.
22. Cornejo-García JA, Guéant-Rodriguez RM, Torres MJ, Blanca- Lopez N, Tramoy D, Romano A, et al. Biological and genetic
determinants of atopy are predictors of immediate-type allergy to betalactams, in Spain. Allergy. 2012 Sep;67(9):1181-5.
23. Blanca-López N, Cornejo-García JA, Pérez-Alzate D, Pérez- Sánchez N, Plaza-Serón MC, Doña I, et al. Hypersensitivity
Reactions to Nonsteroidal Anti-inflammatory Drugs in Children and Adolescents: Selective Reactions. J Investig Allergol Clin Immunol. 2015;25(6):385-95
24. Pichler WJ, Adam J, Daubner B, Gentinetta T, Keller M, Yerly D. Drug hypersensitivity reactions: Pathomechanism and clinical symptoms. Med Clin N Am 2010;94:645-64.
25. Pichler WJ. Immun mechanism of drug hypersensitivity. Immunol Clin North Am 2004;373-97.
26. Schnyder B. Approach to the patient with drug allergy. Immu¬nol Allergy Clin North Am 2009; 29: 405-18.
27. Demoly P, Lebel B, Messaad D, Sahla H, Rongier M, Daures JP. Predictive capacity of histamine release for the diagnosis of drug allergy. Allergy 1999;54:500-6.
28. Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy 2002; 57: 45-51.
29. Naisbitt DJ, Farrell J, Wong G, Depta JP, Dodd CC, Hopkins JE, et al. Characterization of drug-specific T cells in lamotrigine
hypersensitivity.J Allergy Clin Immunol. 2003 Jun;111(6):1393-403.
30. Naisbitt DJ, Britschgi M, Wong G, Farrell J, Depta JP, Chadwick DW, et al. Hypersensitivity reactions to carbamazepine:
characterization of the specificity, phenotype, and cytokine profile of drug-specific T cell clones. Mol Pharmacol. 2003 Mar;63(3):732-41.
31. Brockow K, Romano A. Skin tests in the diagnosis of drug hypersensitivity reactions. Curr Pharm Des. 2008;14(27):2778-91.
32. Lezmi G, Alrowaishdi F, Bados-Albiero A, Scheinmann P, de Blic J, Ponvert C. Non-immediate-reading skin tests and prolonged
challenges in non-immediate hypersensitivity to betalactams in children. Pediatr Allergy Immunol. 2018 Feb;29(1):84-89
33. Romano A, Blanca M, Torres MJ, et al. ENDA; EAACI. Diagnosis of nonimmediate reactions to beta-lactam antibiotics. Allergy 2004; 59: 1153-60.
34. Tonson la Tour A, Michelet M, Eigenmann PA, Caubet JC. Natural History of Benign Nonimmediate Allergy to Beta-Lactams
in Children: A Prospective Study in Retreated Patients After a Positive and a Negative Provocation Test. J Allergy Clin Immunol Pract. 2018 Jul - Aug;6(4):1321-1326.
35. Joint Task Force on Practice Parameters; American Academy of Allergy, Asthma and Immunology; American College of Allergy,
Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Drug allergy: an updated practice

Ayrıntılar

Birincil Dil

Türkçe

Konular

İç Hastalıkları

Bölüm

Derleme

Yazarlar

Deniz Özçeker ^* Bu kişi benim
Türkiye

Yayımlanma Tarihi

1 Nisan 2020

Gönderilme Tarihi

5 Şubat 2020

Kabul Tarihi

-

Yayımlandığı Sayı

Yıl 2020 Cilt: 12 Sayı: 2

IZ

https://izlik.org/JA85HE53SB

Kaynak Göster

RIS / Bibtex

APA

Özçeker, D. (2020). Çocuklarda İlaç Alerjileri. Klinik Tıp Pediatri Dergisi, 12(2), 120-126. https://izlik.org/JA85HE53SB

AMA

1.Özçeker D. Çocuklarda İlaç Alerjileri. Pediatri. 2020;12(2):120-126. https://izlik.org/JA85HE53SB

Chicago

Özçeker, Deniz. 2020. “Çocuklarda İlaç Alerjileri”. Klinik Tıp Pediatri Dergisi 12 (2): 120-26. https://izlik.org/JA85HE53SB.

EndNote

Özçeker D (01 Nisan 2020) Çocuklarda İlaç Alerjileri. Klinik Tıp Pediatri Dergisi 12 2 120–126.

IEEE

[1]D. Özçeker, “Çocuklarda İlaç Alerjileri”, Pediatri, c. 12, sy 2, ss. 120–126, Nis. 2020, [çevrimiçi]. Erişim adresi: https://izlik.org/JA85HE53SB

ISNAD

Özçeker, Deniz. “Çocuklarda İlaç Alerjileri”. Klinik Tıp Pediatri Dergisi 12/2 (01 Nisan 2020): 120-126. https://izlik.org/JA85HE53SB.

JAMA

1.Özçeker D. Çocuklarda İlaç Alerjileri. Pediatri. 2020;12:120–126.

MLA

Özçeker, Deniz. “Çocuklarda İlaç Alerjileri”. Klinik Tıp Pediatri Dergisi, c. 12, sy 2, Nisan 2020, ss. 120-6, https://izlik.org/JA85HE53SB.

Vancouver

1.Deniz Özçeker. Çocuklarda İlaç Alerjileri. Pediatri [Internet]. 01 Nisan 2020;12(2):120-6. Erişim adresi: https://izlik.org/JA85HE53SB