Drug Hypersensitivity Reactions: Are There Differences Between Children And Adults?

Abstract

RATIONALE: Drug hypersensitivity reactions (DHR) affect about 7% of the general population; they may be unpredictable and represent a lifethreatening risk. The study aimed to analyze the clinical profile and possible differences between children and adults that presented a DHR. METHODS: Retrospective data analysis of patients evaluated in 10 specialized centers in Brazil, from March 2016 to June 2018. Cases with probable or confirmed diagnosis were included. Children (less than 18 years old) and adults were compared according to clinical and epidemiological data, and a 5% level of significance was established (p<0,05). RESULTS: Eighty-one percent of patients (262/321) had a probable or confirmed diagnosis of DHR. Female gender was predominant in adults (83%) and children (55%). Immediate reactions were more frequent in adults (68%) than in children (48%), where non-immediate reactions were prevailing (52%). Fever and/or infectious diseases were observed in 59% of children with DHR, compared to 12% of adults. NSAIDs were reported as the culprit drug in 74% of adults and 53% of children. On the other hand, antibiotics were involved in 46% of the reactions in children, but just in 12% of adults. There were no significant differences between groups regarding clinical presentation, severity of symptoms, personal history of atopy or family history of DHR. CONCLUSIONS: The DHR profile in adults and children differs in time to reaction, presence of related co-factors and drugs involved. These differences may represent essential tools to help the diagnosis and management of DHR in clinical practice.