Allergic Reactions in the Perioperative Period in Children

Uribe, Victor; Rodríguez, Elsy Maureen Navarrete

doi:10.4172/2155-6121.1000238

Cited by 1 publication

(1 citation statement)

References 77 publications

(107 reference statements)

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“…Characteristic symptoms such as vertigo, dyspnea and malaise are missing in anesthetized patients. Cutaneous manifestations, such as urticaria and angioedema, sudden cardiac arrest, hypotension, and severe bronchoconstriction are highly evocative of anaphylaxis [ 24 ]. Drug hypersensitivity in our patients was confirmed in three children who developed only skin manifestations.…”

Section: Discussionmentioning

confidence: 99%

Diagnosing Single and Multiple Drug Hypersensitivity in Children: A Tertiary Care Center Retrospective Study

Milošević

Malinic²,

Plavec

et al. 2022

Children

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Drug hypersensitivity reactions (DHRs) are a type of adverse drug reactions with heterogeneous pathophysiological mechanisms and a broad spectrum of clinical manifestations. Since over-diagnosing is common in children, a complete allergy work-up is needed. A cross-sectional study was conducted at a tertiary care institution, covering the five-year period. Five hundred and four patients of both sexes, mean age 7.5 and with a medical history suggestive of DHR were evaluated. ENDA/EAACI guidelines were used for a diagnostic algorithm. Single drug hypersensitivity was registered in 375 patients and multiple drug hypersensitivity in 129. The main culprits in medical history were antibiotics (83%), non-steroidal anti-inflammatory drugs (NSAIDs) (8.4%) and analgoantipyretics (3.8%). Skin involvement was registered in 96.2%. DHRs were confirmed in 4.4% patients—six patients had positive skin tests and 13 had a positive drug provocation test. In the proven DHRs group, the main agents were antibiotics (72.7%), followed by NSAIDs (8.3%), and of all the skin manifestations, urticaria was most common (78.2%), followed by exanthema (10.5%) and angioedema (5.3%). Considering the above, anticipating DHRs and a proper referral of children to an allergologist is a key step in the assessment of drug hypersensitivity. A complete allergy work-up prevents unnecessary drug exclusion and allows most children to safely continue the use of first-line medications when needed.

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Section: Discussionmentioning

confidence: 99%