Descriptive analysis of a simplified approach to low-risk drug hypersensitivity reactions

Espinosa, Diana Lucía Silva; Mejía, Dolly Vanessa Rojas; Zuluaga, Luis Fernando Ramírez; Hernández, Manuela Olaya; Reyes, Carlos Daniel Serrano

doi:10.1016/j.anai.2020.08.396

Cited by 2 publications

(3 citation statements)

References 23 publications

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“…147 In a very recent study involving 217 pediatric and adult cases with NSAID-H from Spain, OPT with etoricoxib was negative in all of the cases and only 5.5% of the participants reacted to meloxicam. 14 Paracetamol has lesser adverse reactions and fewer cross-reactions with NSAIDs than other COX-I inhibitors, 36,117 but still might cross-react with COX-I inhibitors at high doses of 15 mg/kg. 148 Topal et al reported two children who reacted to high-dose paracetamol out of eight CI children tolerating low-dose paracetamol.…”

Section: Finding Safe Alternatives: What Are the Options?mentioning

confidence: 99%

“…12,13 When only mild cutaneous reactions were considered, NSAIDs were also the drugs that resulted in the highest positivity rates during provocation tests in both groups. 14 NSAIDs were also reported as the primary elicitors of drug-induced anaphylaxis, not only in adults but also in children and adolescents, comprising more than 40% of all drug-induced anaphylactic reactions. [15][16][17][18] There are certain challenging aspects of NSAID-hypersensitivity (NSAID-H) in the pediatric population that need to be further investigated.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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NSAID Hypersensitivity in the Pediatric Population: Classification and Diagnostic Strategies

Cavkaytar¹,

Arga²

2022

JAA

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Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most frequently administered drugs, mainly for their antipyretic, but also for pain-relieving and anti-inflammatory effects in children. NSAIDs are composed of structurally divergent subgroups of drugs with similar pharmacological and adverse effects. Aspirin originates from salicin and was the first synthesized analgesic. As a prototype of NSAIDs; aspirin-induced hypersensitivity reactions were first reported, but subsequently, other phenotypes of hypersensitivity reactions were also described with aspirin and other NSAIDs. There are certain challenging aspects of NSAID-hypersensitivity in the pediatric population that need to be further investigated. These include the effect of age on drug metabolism and the natural history of the various phenotypes of NSAID-hypersensitivity, the effect of certain co-factors (infections, exercise) on NSAID-hypersensitivity, and diagnostic clinical and laboratory biomarkers clarifying the endotypes. In recent years, a non-negligible number of case series, studies and expert panel reports have been published in this field with some novel features and diagnostic modalities in the pediatric population. With the current review; the clinical phenotypes and diagnostic and management modalities of suspected NSAID-induced hypersensitivity reactions in childhood and adolescence were explained and updated by examining past and current publications.

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Section: Finding Safe Alternatives: What Are the Options?mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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NSAID Hypersensitivity in the Pediatric Population: Classification and Diagnostic Strategies

Cavkaytar¹,

Arga²

2022

JAA

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Reproducibilidad clínica de reacciones de hipersensibilidad a fármacos en pruebas de exposición controlada

Palacios Cañas,

Meneses Sotomayor,

Clar Castelló

et al. 2023

Rev Alerg Mex

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Objetivo: Evaluar la reproducibilidad de los síntomas en pruebas de exposición con fármacos. Métodos: Estudio retrospectivo, efectuado en pacientes con prueba cutánea o exposición positiva, atendidos en 2019. De cada paciente se registró la sospecha clínica según el algoritmo de Karch-Lasagna. El resultado principal fue la reproducibilidad de síntomas en las pruebas de exposición, mediante el análisis de datos emparejado con prueba de McNemar. Resultados: Se incluyeron 89 pacientes, y de estos 16 reportaron varias pruebas positivas. Se obtuvieron 30 pruebas cutáneas y 75 de exposición positivas. En el 89% de las pruebas de exposición positivas, las reacciones iniciales se clasificaron en probables o posibles, según la escala de Karch-Lasagna. Los síntomas reportados en la reacción inicial no difirieron de los de las pruebas de exposición. Conclusión: La escala de Karch-Lasagna es un método útil para predecir la respuesta en las pruebas de exposición con fármacos. En la mayor parte de las pruebas positivas, los resultados fueron sugeridos por la historia clínica, sin diferencias entre la manifestación de síntomas en la prueba de exposición versus los referidos en la reacción inicial.

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Descriptive analysis of a simplified approach to low-risk drug hypersensitivity reactions

Cited by 2 publications

References 23 publications

NSAID Hypersensitivity in the Pediatric Population: Classification and Diagnostic Strategies

NSAID Hypersensitivity in the Pediatric Population: Classification and Diagnostic Strategies

Reproducibilidad clínica de reacciones de hipersensibilidad a fármacos en pruebas de exposición controlada

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