Characteristics of drug-induced anaphylaxis in children and adolescents

Cavkaytar, Özlem; Karaatmaca, Betül; Çetinkaya, Pınar Gür; Esenboğa, Saliha; Yılmaz, Ebru; Şahiner, Ümit Murat; Şekerel, Bülent Enis; Soyer, Özge

doi:10.2500/aap.2017.38.4064

Cited by 18 publications

(24 citation statements)

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“…About one quarter of the cases was designated as atopic/allergic; similar results were reported in other studies . Although preferential underreporting cannot be excluded, atopy was not confirmed as a risk factor for severe reactions in our study, which is also in accordance with literature …”

Section: Discussionsupporting

confidence: 91%

“…Largely in accordance with a recent study, the majority of anaphylactic reactions was classified as moderate (77.4%; grade I/II). Likewise, only one of 159 cases reported a fatal outcome.…”

Section: Discussionsupporting

confidence: 89%

“…Some publications have reported atopy and allergy as risk factors for severe courses of anaphylaxis whereas others have not . However, risk factors and cofactors may differ between age groups or according to the underlying pathophysiology and are not sufficiently studied in children …”

Section: Introductionmentioning

confidence: 99%

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Drug‐induced anaphylactic reactions in children: A retrospective analysis of 159 validated spontaneous reports

Sachs

Dubrall

Fischer-Barth

et al. 2019

Pharmacoepidemiology and Drug

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Purpose The main objective of this study was to analyze validated cases of drug‐induced anaphylactic reactions in children with regard to incriminated drugs, clinical characteristics, and associated factors. A further objective was to compare differences in incriminated drugs and characteristics between validated cases and a reference excluding anaphylactic reaction cases (basic dataset). Methods Spontaneous reports of anaphylactic reactions in children (0‐17 years) registered between January 2000 to December 2016 were extracted from the adverse drug reaction database of the German Federal Institute for Drugs and Medical Devices. These reports were restricted to drugs for which at least four cases were found. After case validation, 159 reports remained (validated dataset) and were compared with the basic dataset (n = 12.168 reports) using inferential statistics. Results Estimated yearly increase of reports (36.8 vs 0.1), most frequently incriminated drugs (antibiotics 30.2% vs 11%, analgesics/antipyretics 22.0% vs 5.6%; P values less than 0.001) and route of administration (38.4% vs 6.7%) differed between the validated dataset and the basic dataset. Validated cases differed in severity (higher with atracurium), reported symptoms (urticaria leading with analgesics), and associated factors (atopy/allergy rarely reported with antibiotics) depending on the incriminated drug class. In 13.8% (11.3% if excluding repeated readministration in one person) of the cases, the drug had not been tolerated before. Conclusions A heterogeneous clinical phenotype with differences in associated factors was observed, suggesting different underlying mechanisms triggered by the different drug groups. Occurrence of serious drug‐induced anaphylactic reactions in children could be reduced by carefully considering patient history.

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Section: Discussionsupporting

confidence: 91%

“…Largely in accordance with a recent study, the majority of anaphylactic reactions was classified as moderate (77.4%; grade I/II). Likewise, only one of 159 cases reported a fatal outcome.…”

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

Drug‐induced anaphylactic reactions in children: A retrospective analysis of 159 validated spontaneous reports

Sachs

Dubrall

Fischer-Barth

et al. 2019

Pharmacoepidemiology and Drug

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“…[6][7][8][9] Regarding SCARs, the drugs involved depend on the population (adults or children). In this sense, antibiotics and anticonvulsants are the most common ones in adults 10 ; and antibiotics, NSAIDs, and chemotherapeutics 11 as well as aromatic anticonvulsants and also allopurinol are the most frequently involved in children. [12][13][14] Over the last years, DHRs to new drugs as monoclonal antibodies, sulphasalazine and antituberculosis drugs have also been reported.…”

Section: The Burden Of Drug Hyper S En S Itivit Ymentioning

confidence: 99%

Recent developments and highlights in drug hypersensitivity

Mayorga

Fernandez

Montañez

et al. 2019

Allergy

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Drug hypersensitivity reactions (DHRs) are nowadays the third cause of allergy after rhinitis and asthma with a significant increase in prevalence in both adults and paediatric population with new drugs included as culprit. For this, DHRs represent not only a health problem but also a significant financial burden for affected individuals and health systems. Mislabelling DHRs is showing to be a relevant problem for both, false label of drug allergic and false label of nonallergic. All this reinforces the need to improve accurate diagnostic approaches that allow an appropriate management.Moreover, there is a need for training both, nonallergist stakeholders and patients to improve the reaction identification and therefore decrease the mislabelling. The use of allergy cards has shown to be relevant to avoid the induction of DHRs due to the prescription of wrong medication.Recent developments over the last 2 years and highlights about risk factors, diagnostic approaches, mechanisms involved as well as prevention actions, and management have been reviewed. In these papers, it has been outlined the need for correct diagnosis and de-labelling of patients previously false-reported as allergic, which will improve the management and treatment of patients with DHRs. K E Y W O R D Sallergy diagnosis, allergy treatment, basic mechanisms, drug allergy, epidemiology | 2369

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“…This issue also features two studies that addressed the diagnosis of drug allergy in pediatric populations. Cavkaytar et al 4 reported the diagnostic accuracy of drug-related anaphylaxis histories in defining the etiology of drug-induced anaphylaxis, with severity and culprit drug associations. The clinical characteristics of pediatric patients diagnosed with immediate type ␤-lactam hypersensitivity were evaluated in a second study, by Misirlioglu et al, 5 which also included a cohort of patients with hypersensitivity limited to a specific drug side chain.…”

mentioning

confidence: 99%