Drug-induced anaphylaxis—elicitors, mechanisms and diagnosis

Worm, Margitta; Hanschmann-Mohn, Theresa; Hofmeier, Kathrin Scherer; Cardona, Victòria; Turner, Paul J.; Dölle‐Bierke, Sabine

doi:10.1007/s40629-019-00109-2

Cited by 9 publications

(10 citation statements)

References 9 publications

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“…In other studies, anaphylactic reactions occurred more frequently in association with penicillins than with cephalosporins [ 46 , 47 , 48 ]. In a recent study of the German Anaphylaxis Registry, the use of a penicillin was reported in 41% and the use of a cephalosporin in 32% of the analyzed anaphylactic reactions [ 49 ]. In contrast, in a study from the Allergy Center in Würzburg, 84.3% of confirmed immediate-type reactions were caused by cephalosporins [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Descriptive analysis of adverse drug reaction reports for hypersensitivity reactions stratified in relation to different beta-lactam antibiotics

Dubrall

Schulz

Schmid

et al. 2022

ALS

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β-lactam antibiotics (BLA) are commonly reported to induce hypersensitivity reactions. However, β-lactam antibiotic-stratified analyses are rare. In the presented study, β-lactam antibiotic associated hypersensitivity reactions were analyzed in the European adverse drug reaction (ADR) database. 923, 38, 222, and 99 hypersensitivity reports for penicillins and first-, second- and third-generation cephalosporins were reported. Differences with regard to demographical parameters, seriousness and types of hypersensitivity reactions, as well as in the number of hypersensitivity reports per outpatient prescriptions were observed between the different β-lactam antibiotics. The number of ADR reports classified as serious was higher for all generations of cephalosporins compared to penicillins. Additionally, anaphylactic reactions were more often reported for first- and second-generation cephalosporins compared to third-generation cephalosporins and penicillins, while bullous reactions were more often reported for first- and third-generation cephalosporins as opposed to second-generation cephalosporins and penicillins. The observed differences may be caused by differences between β-lactam antibiotics and their routes of administration (oral, intravenous), the patient populations, or the reporting of ADRs. Due to the methodological limitations of ADR database analysis, no conclusions can be drawn whether and to what extent the aforementioned factors influenced our results.

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Section: Discussionmentioning

confidence: 99%

Descriptive analysis of adverse drug reaction reports for hypersensitivity reactions stratified in relation to different beta-lactam antibiotics

Dubrall

Schulz

Schmid

et al. 2022

ALS

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“…So far drug and/or vaccine induced hypersensitivity reactions can be caused either IgE-dependent, via a G-protein signalling pathway (MRG-PX2) or through activation of the complement system [12]. Whether PEGs or other vaccine excipients are capable to induce a hypersensitivity reaction besides the IgE dependent pathway is currently not known.…”

Section: Discussionmentioning

confidence: 99%

Management and outcome of suspected and confirmed COVID-19 (SARS-CoV-2) vaccine hypersensitivity.

Worm¹,

Fluhr²,

Pfützner³

et al. 2021

Preprint

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Systemic allergic reactions to vaccines are very rare. In this study we assessed the management and outcome suspected SARS-CoV-2 vaccine hypersensitivity. We present data of 219 individuals, who experienced symptoms suspicious for an allergic reaction after the first (n=214) or the second vaccination (n=5). 195 reactions occurred after the first application of mRNA-based vaccines (157 Comirnaty®, and 38 Spikevax®) and eighteen reactions were reported after first application of a vector vaccine (Vaxzevria®). Of these 162 experienced immediate symptoms. Skin symptoms occurred in 91 cases. The most frequent cutaneous symptom was angioedema (n=45), followed by generalized urticaria (n=36) and generalized erythema/flush (n=20). 70 patients had cardiovascular symptoms, 45 showed respiratory symptoms and gastrointestinal symptoms were recorded in 14 patients. The allergological assessment of 334 individuals (219 with reactions after COVID vaccination and 115 with a history of vaccine related reactions) showed in 17% a suspicion of sensitization against the SARS-CoV-2 vaccine and/or their ingredients defined as one positive skin test and/or BAT. The majority of the SPT/IDT with the vaccines were negative. Of the 214 patients with suspected allergic symptoms after the first vaccination, 67/67 patients tolerated the re-vaccination. In this study, 334 individuals of a cohort resembling >2000 persons presenting for an allergy workup regarding SARS-CoV-2 vaccination only 45 were diagnosed in concordance with the anaphylaxis definition of the Brighton collaboration with anaphylactic immediate hypersensitivity reaction after SARS-CoV-2 vaccination. Identifiable characteristics of these patients with suspected, but also diagnosed SARS-CoV-2 vaccine hypersensitivity were female gender and the symptom angioedema. Overall, IgE-mediated hypersensitivity towards SARS-CoV-2 vaccines is extremely low and not increased in comparison to the reported hypersensitivity for other vaccines.

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“…Wir kennen allergische und anaphylaktische Reaktionen auf Wirk-und Zusatzstoffe von jeder Art von Impfstoffen, aber auch von Biologika und vielen anderen Medikamenten [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44].…”

Section: Diskussion Und Zusammenfassungunclassified

Allergische Reaktionen auf COVID-19-Impfungen – Was HNO-Ärzte wissen sollten – Teil 1: Allgemeine Aspekte von Allergien auf Impfstoffe, immunologische Grundlagen von Allergien auf Impfstoffe, Immunmechanismen von allergischen und pseudoallergischen Reaktionen; Teil 2: Charakteristiken der mRNA-Impfstoffe BNT162b2 und mRNA-1273 zur Prophylaxe von COVID-19, weitere Impfstoff-Kandidaten und assoziierte Immunphänomene; Teil 3: Praktische Aspekte der Prophylaxe, Diagnostik und Therapie von Allergien auf COVID-1

Klimek

Chaker

Cuevas

2021

Laryngorhinootologie

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ZusammenfassungImpfungen sind der Goldstandard zur Prophylaxe gefährlicher Infektionserkrankungen. Innerhalb weniger als 12 Monaten seit Entschlüsselung der kodierenden RNA-Sequenzen von SARS-CoV-2 wurden bereits 2 RNA-Impfstoffe gegen COVID-19 in wesentlichen Teilen der Welt zugelassen und seit Dezember 2020 eingesetzt. Der Herausforderung durch eine beispiellose globale Pandemie folgte in bisherig einmaliger Art und Weise der Zusammenarbeit und koordinierten Antwort die Entwicklung verschiedener Impfstoffe basierend auf unterschiedlichen Technologieplattformen. In diesem Artikel werden die verschiedenen Charakteristiken der in Prüfung befindlichen sowie bereits zugelassenen Impfstoffe dargestellt und erklärt, z. B. Subunit-Impfstoffe, inaktivierte Vollimpfstoffe, abgeschwächte Lebendimpfstoffe und Virus-like-Particle (VLP) -Impfstoffe. Die neuartigen rekombinanten Impfstoffstrategien basierend auf adenoviralen Vektoren sowie die durch die schnelle Entwicklung und erstmalige Zulassung in den Fokus gerückten RNA-Impfstoffe sowie ihre Biologie und Pharmakologie werden erläutert. Allergische Reaktionen gegen diese Impfstoffe und Bestandteile existieren, sind aber selten. Immunreaktionen sowie Nebenwirkungen sollten gut dokumentiert werden. In seltenen Fällen einer vermuteten Allergie gegen Impfstoffbestandteile, vor allem gegen PEGs, ist eine präemptive Hauttestung möglich. Die Entwicklung innovativer Impfstofftechnologien und antiviraler Medikamente ist von strategischer Bedeutung im Sinne einer zukünftigen „pandemic preparedness“.

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Drug-induced anaphylaxis—elicitors, mechanisms and diagnosis

Cited by 9 publications

References 9 publications

Descriptive analysis of adverse drug reaction reports for hypersensitivity reactions stratified in relation to different beta-lactam antibiotics

Descriptive analysis of adverse drug reaction reports for hypersensitivity reactions stratified in relation to different beta-lactam antibiotics

Management and outcome of suspected and confirmed COVID-19 (SARS-CoV-2) vaccine hypersensitivity.

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