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Hypersensitivity Reaction

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181. Evaluation of Prospective HLA-B*13:01 Screening to Prevent Dapsone Hypersensitivity Syndrome in Patients With Leprosy. (PubMed)

Evaluation of Prospective HLA-B*13:01 Screening to Prevent Dapsone Hypersensitivity Syndrome in Patients With Leprosy. Dapsone hypersensitivity syndrome (DHS) is the most serious adverse reaction associated with dapsone administration and one of the major causes of death in patients with leprosy, whose standard treatment includes multidrug therapy (MDT) with dapsone, rifampicin, and clofazimine. Although the HLA-B*13:01 polymorphism has been identified as the genetic determinant of DHS (...) received standard MDT.The primary outcome was the incidence of DHS. The historical incidence rate of DHS (1.0%) was used as a control.Among 1512 patients (1026 [67.9%] men, 486 [32.1%] women; mean [SD] age, 43.1 [16.2] years), 261 (17.3%) were identified as carriers of the HLA-B*13:01 allele. A total of 714 adverse events in 384 patients were observed during the follow-up period. Dapsone hypersensitivity syndrome did not develop in any of the 1251 patients who were HLA-B*13:01-negative who received

2019 JAMA dermatology (Chicago, Ill.)

182. Level of contact hypersensitivity response to diphencyprone and keratinocyte cancer. (PubMed)

), which elicits a contact hypersensitivity reaction in skin, to compare the degree of reactivity to DPCP in patients with a high KC burden versus those with a low KC burden.A prospective study was performed in immunocompetent patients aged 70 ± 5 years of age, comparing patients with a high KC burden (>10 previous KC) with those with a low KC burden (<2 previous KC). All patients were sensitized with 2% DPCP and then patch tested two weeks later with eight different concentrations of DPCP (...) required a higher threshold concentration of DPCP to elicit a hypersensitivity reaction, supporting the concept of a lower skin immunity in these patients. DPCP reactivity threshold could be a useful tool in the evaluation of skin immunity and propensity to develop keratinocyte cancers.© 2019 European Academy of Dermatology and Venereology.

2019 Journal of the European Academy of Dermatology and Venereology

183. Hypersensitivity to monoclonal antibodies used for cancer and inflammatory or connective tissue diseases. (PubMed)

Hypersensitivity to monoclonal antibodies used for cancer and inflammatory or connective tissue diseases. To review the medical literature on hypersensitivity reactions to therapeutic monoclonal antibodies for patients with malignant tumors and chronic inflammatory or connective tissues diseases.We searched the PubMed database using the terms monoclonal antibody, hypersensitivity, and allergy.We selected case reports and cohort studies of patients with hypersensitivity reactions to monoclonal (...) , and because new agents are added to the set at a relatively high rate, it is difficult to determine precisely the incidence of reactions to this class of drugs as a whole. The classification of a specific hypersensitivity reaction depends mainly on the medical history. Skin testing may be available but often is not validated and may be prohibitively expensive. Avoidance of the culpable agent is ideal, but if treatment with the responsible drug is necessary, rapid drug desensitization is an option for type

2019 Asthma & Immunology

184. Characteristics of venom allergy at initial evaluation: Is fire ant hypersensitivity similar to flying Hymenoptera? (PubMed)

Characteristics of venom allergy at initial evaluation: Is fire ant hypersensitivity similar to flying Hymenoptera? Hymenoptera venom allergy (HVA) is a well-established cause of anaphylaxis; however, studies comparing patients with imported fire ant (IFA) to flying hymenoptera (FH) allergies are lacking.This study sought to characterize the initial presentation and examine differences between patients with IFA and FH reactions.A multi-year (2007-2014), observational, single-institution (...) analysis of patients referred for evaluation of HVA was performed. Data was obtained via physician interview, chart review and specific IgE results.175 patients were enrolled with no difference between FH and IFA patients when analyzing mean age, sex or likelihood to seek ED care. Asthma was similar in all groups at 21%. ED treatments were also similar (epinephrine: 32/150, 21%; antihistamines: 141/155, 91%; corticosteroids: 67/148, 45%). Reaction severity correlated with likelihood of ED visit (p

2019 Asthma & Immunology

185. Suppression of aspirin-mediated eosinophil activation by prostaglandin E<sub>2</sub>: Relevance to aspirin and nonsteroidal anti-inflammatory drug hypersensitivity. (PubMed)

Suppression of aspirin-mediated eosinophil activation by prostaglandin E2: Relevance to aspirin and nonsteroidal anti-inflammatory drug hypersensitivity. Aspirin-exacerbated respiratory disease (AERD) is characterized by severe, sometimes life-threatening reactions to nonsteroidal anti-inflammatory drugs (NSAIDs). Mechanisms driving the disease include overproduction of leukotrienes and loss of anti-inflammatory prostaglandin E2 (PGE2) production. Many cell types contribute

2019 Asthma & Immunology

186. Recent developments and highlights in drug hypersensitivity. (PubMed)

Recent developments and highlights in drug hypersensitivity. 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 or false label of non-allergic. All this reinforces the need to improve accurate diagnostic approaches that allow an appropriate management. Moreover, there is a need for training both non-allergist 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 two years and highlights

2019 Allergy

187. Two approaches for diagnosis of nonsteroidal anti-inflammatory drug hypersensitivity in children. (PubMed)

Two approaches for diagnosis of nonsteroidal anti-inflammatory drug hypersensitivity in children. The oral provocation test (OPT) with culprit drug is the gold standard in the diagnosis of nonsteroidal anti-inflammatory drug hypersensitivity (NSAID-H). Some authors have proposed that the total number of OPTs required to diagnose NSAID-H is much lower with acetyl salicylic acid (ASA) provocations, regardless of patients' reaction history, and less time consuming.This study aims to evaluate (...) the total number of OPTs required to confirm NSAID-H according to the drugs (ASA or culprit NSAID) used in the initial OPT.The study included patients with a history of NSAID-H. Data on the demographic and clinical features, coexisting chronic or allergic disease, and laboratory results were collected from medical records. The drug used for the initial OPT (ASA or culprit NSAID), results of the OPT, and the total number of OPTs were reviewed.We included 56 children with suspected hypersensitivity

2019 Asthma & Immunology

188. Short and extended provocation tests have similar negative predictive value in non-immediate hypersensitivity to beta-lactams in children. (PubMed)

Short and extended provocation tests have similar negative predictive value in non-immediate hypersensitivity to beta-lactams in children. Drug provocation tests (DPTs) are the gold-standard method to diagnose non-immediate hypersensitivity reactions (NIHSR) to beta-lactam antibiotics (BL) in children. Our aim was to compare the negative predictive value (NPV) of one-day (short) DPT versus 3-7 days (extended) DPT for the diagnosis of NIHSR to BL in paediatric age. A secondary aim was to compare

2019 Allergologia et immunopathologia Controlled trial quality: uncertain

189. Systematic review of cross-reactivity to neuromuscular junction (NMJ) blocker hypersensitivity reactions in the perioperative setting

Systematic review of cross-reactivity to neuromuscular junction (NMJ) blocker hypersensitivity reactions in the perioperative setting Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne

2018 PROSPERO

190. Allopurinol Use and Risk of Fatal Hypersensitivity Reactions: A Nationwide Population-Based Study in Taiwan. (PubMed)

Allopurinol Use and Risk of Fatal Hypersensitivity Reactions: A Nationwide Population-Based Study in Taiwan. Allopurinol, a first-line drug used for treating gout, is increasingly prescribed worldwide to patients with asymptomatic hyperuricemia and comorbid renal or cardiovascular diseases. Nevertheless, allopurinol use has been associated with fatal hypersensitivity reactions, including drug rash with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necrolysis (...) ). They also had statistically significantly increased risk of mortality (OR, 5.59; 95% CI, 2.61-11.94; P < .001 for renal diseases and OR, 3.57; 95% CI, 2.31-5.51; P < .001 for cardiovascular diseases).The use of allopurinol in patients with asymptomatic hyperuricemia accompanied by renal or cardiovascular diseases statistically significantly increased the risk of hypersensitivity reactions. Physicians should be cautious when prescribing allopurinol to high-risk populations and should consider

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2015 JAMA Internal Medicine

191. Skin tests in patients with hypersensitivity reaction to iodinated contrast media: a meta-analysis. (PubMed)

Skin tests in patients with hypersensitivity reaction to iodinated contrast media: a meta-analysis. Patients with a previous history of hypersensitivity reaction (HSR) to iodinated contrast media (ICM) are at high risk of the development of HSR to ICM. Many studies have tried to evaluate the diagnostic potential of skin tests in this population but have not yet reached a common conclusion. We investigated the role of skin tests in patients with HSR to ICM in terms of positive rate, cross

2015 Allergy

192. Association of HLA-B*5701 genotypes and abacavir-induced hypersensitivity reaction: a systematic review and meta-analysis.

Association of HLA-B*5701 genotypes and abacavir-induced hypersensitivity reaction: a systematic review and meta-analysis. This study aimed to systematically review and quantitatively synthesize the association between HLA-B*5701 and abacavir-induced hypersensitivity reaction (ABC-HSR).We searched for studies that investigated the association between HLA-B genotype and ABC-HSR and provided information about the frequency of carriers of HLA-B genotypes among cases and controls. We then performed

2015 Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques

193. Hypersensitivity reaction after administration of rivaroxaban (Xarelto). (PubMed)

Hypersensitivity reaction after administration of rivaroxaban (Xarelto). Little has been documented regarding hypersensitivity reactions with rivaroxaban or other factor Xa inhibitors. We report the development of a hypersensitivity reaction to rivaroxaban in a 64-year-old African American male patient who presented to the emergency department and was subsequently evaluated in dermatology consultation and follow-up. This case highlights the vigilance required by health care workers

2015 American Journal of Emergency Medicine

194. Risk stratification and skin testing to guide re-exposure in taxane-induced hypersensitivity reactions. (PubMed)

Risk stratification and skin testing to guide re-exposure in taxane-induced hypersensitivity reactions. The optimal approach to patients with hypersensitivity reactions (HSRs) to taxanes has not been established.We sought to assess the safety and efficacy of risk stratification based on the severity of the initial HSR and skin testing for guiding taxane reintroduction in patients with an HSR to these agents.Data on 164 patients treated for a taxane-related HSR from April 2011 to August 2014

2015 Journal of Allergy and Clinical Immunology

195. Drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome: clinical features of 27 patients. (PubMed)

Drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome: clinical features of 27 patients. Drug reaction with eosinophilia and systemic symptoms (DRESS) [also called drug-induced hypersensitivity syndrome (DIHS)] includes severe reactions to drugs that need to be promptly recognized by physicians.To explore heterogeneity in the clinical presentation of DRESS/DIHS at a large academic hospital in Latin America, using the criteria defined by the European (...) Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) scoring system.A retrospective medical record review of 60 patients with diagnostic suspicion of DRESS/DIHS admitted to our hospital between July 2008 and April 2012 was performed, including demographic data, clinical features, laboratory findings and treatment.Of the 60 patients, 27 fulfilled the criteria for DRESS/DIHS. Maculopapular exanthema (85.1%), fever (96.2%) and hepatic involvement (85.1%) were the most common features. Anticonvulsants

2015 Clinical & Experimental Dermatology

196. Cytotoxic-based assays in delayed drug hypersensitivity reactions induced by aromatic antiepileptics. (PubMed)

Cytotoxic-based assays in delayed drug hypersensitivity reactions induced by aromatic antiepileptics. INTRODUCTION Cytotoxic mechanisms are present in the majority of delayed drug hypersensitivity reactions, but are not used as a diagnostic tool. OBJECTIVES The aim of the study was to compare cytotoxic‑based assays with a proliferation assay and drug patch tests in patients with maculopapular eruptions induced by antiepileptic drugs.Peripheral blood mononuclear cells of 23 patients and 24 (...) , and Grl expression were significantly higher in patients than in controls, while perforin concentrations were not elevated. The sensitivities were 30.4%, 55%, 39.1%, and 17.4% for proliferation, GrB, Grl, and perforin‑based assays, respectively. A significantly higher rate of positive results was observed when assays were done within 2 years after a drug‑induced reaction. The specificities of all assays remained in the range of 95.8% to 100%. The results of patch tests were positive only in 3 patients

2015 Polskie Archiwum Medycyny Wewnetrznej

197. Pompholyx as a clinical manifestation suggesting increased serum immunoglobulin G (IgG) levels in a patient with drug-induced hypersensitivity syndrome / drug reaction with eosinophilia and systemic symptoms (DiHS/DRESS). (PubMed)

Pompholyx as a clinical manifestation suggesting increased serum immunoglobulin G (IgG) levels in a patient with drug-induced hypersensitivity syndrome / drug reaction with eosinophilia and systemic symptoms (DiHS/DRESS). 26412450 2017 01 03 2017 01 04 1365-2133 174 3 2016 Mar The British journal of dermatology Br. J. Dermatol. Pompholyx as a clinical manifestation suggesting increased serum IgG levels in a patient with drug-induced hypersensitivity syndrome/drug reaction with eosinophilia (...) of Medicine, 6-20-2 Shinkawa Mitaka, Tokyo, 181-8611, Japan. eng Case Reports Letter Research Support, Non-U.S. Gov't 2015 11 20 England Br J Dermatol 0004041 0007-0963 0 Anticonvulsants 0 Immunoglobulin G 33CM23913M Carbamazepine IM Adult Anticonvulsants adverse effects Carbamazepine adverse effects Drug Hypersensitivity Syndrome etiology immunology Eczema, Dyshidrotic chemically induced immunology Eosinophilia chemically induced immunology Epilepsy drug therapy Female Humans Immunoglobulin G metabolism

2015 British Journal of Dermatology

198. Immediate hypersensitivity reactions to corticosteroids. (PubMed)

Immediate hypersensitivity reactions to corticosteroids. To review the literature on immediate hypersensitivity reactions to corticosteroids and classify them according to manifestations, routes of exposure, causative preparations, diagnostic tests, and management.PubMed search for English-language publications from January 1, 2004 through December 31, 2014 using search terms corticosteroid, glucocorticoid, or steroid combined with hypersensitivity, allergy, or anaphylaxis.Only reports (...) of immediate hypersensitivity reactions that occurred sooner than 24 hours after administration of a corticosteroid were included. Excluded were reports on patients with delayed reactions, including contact dermatitis.Forty-eight articles fulfilled the criteria, reporting 120 reactions in 106 patients 2 to 90 years of age (55 male and 51 female). The most commonly reported manifestation was anaphylaxis in 60.8% (73 of 120) followed by urticaria and/or angioedema in 26.7%. Exposure to corticosteroid

2015 Asthma & Immunology

199. CD32a antibodies induce thrombocytopenia and type II hypersensitivity reactions in FCGR2A mice. (PubMed)

CD32a antibodies induce thrombocytopenia and type II hypersensitivity reactions in FCGR2A mice. The CD32a immunoglobulin G (IgG) receptor (Fcγ receptor IIa) is a potential therapeutic target for diseases in which IgG immune complexes (ICs) mediate inflammation, such as heparin-induced thrombocytopenia, rheumatoid arthritis, and systemic lupus erythematosus. Monoclonal antibodies (mAbs) are a promising strategy for treating such diseases. However, IV.3, perhaps the best characterized CD32a (...) -blocking mAb, was recently shown to induce anaphylaxis in immunocompromised "3KO" mice. This anaphylactic reaction required a human CD32a transgene because mice lack an equivalent of this gene. The finding that IV.3 induces anaphylaxis in CD32a-transgenic mice was surprising because IV.3 had long been thought to lack the intrinsic capacity to trigger cellular activation via CD32a. Such an anaphylactic reaction would also limit potential therapeutic applications of IV.3. In the present study, we examine

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2015 Blood

200. Type I hypersensitivity reaction as a complication of lepa (PubMed)

Type I hypersensitivity reaction as a complication of lepa Adverse drug reaction is defined as response to a drug which is noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis or therapy of disease, or for the modification of physiological functions. Type I hypersensitivity reaction is known as anaphylactic reaction which is due to immediate immunoglobulin E-mediated reaction. It is characterized by symptoms such as fever nausea, back pain (...) therapy is lepa. Even though lepa is said as "Aadhya Upakrama," undue hypersensitivity is observed in many patients. A 60-year-old woman had an adverse reaction to lepa after being administered as an external medication. The observations were erythema, eruptions, and itching. Such case of hypersensitivity is discussed in the present study.

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2015 Journal of basic and clinical pharmacy

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