ABSTRACT
The review article discusses the current data on the mechanisms of hypersensitivity drugs reactions (HDRs). The relevance of the problem is associated with a significant prevalence of adverse drug reactions, in the structure of which immune allergic reactions occupy a significant proportion. Adverse drug reactions, according to the literature, occur in 10-20% of hospitalized patients and about 25% of outpatients. A serious problem of HDRs is their overdiagnosis, which affects the results of individual treatment and can have serious consequences in case of misdiagnosis, because it causes appropriate restrictions in the use of necessary drugs. Purpose - to analyze current views and recommendations on the problem of drug allergy;to highlight the issues of the 2022 meeting, which highlighted the problems of drug hypersensitivity. In particular, to show the relationship between viral infections and severe skin reactions, such as skin lesion syndrome with eosinophilia and systemic disorders. The article reviews and proposes algorithms that can be used to prevent the development of complications caused by HDRs. The materials of the article are based on the results of the European Meeting organized by the European Association of Allergists and Immunologists in 2022 in Verona, Italy. In the conclusions it is noted that despite the interest of the health care system and the large number of studies and publications on the problem of drug allergy, today there is an urgent need for accurate diagnostic approaches that will ensure the correct identification of the suspected drug by a combination of necessary tests and determine the cause for the possibility of prescribing appropriate treatment. The new mechanisms, phenotypes and endotypes of HDRs to drug responses discussed in the review are the future keys to preventing further exposure to harmful drugs. Preliminary pharmacogenomic screening (identification of specific human leukocyte antigen genotypes associated with severe skin adverse reactions) for patients of certain groups before prescribing high-risk drugs may become the future for Ukraine. © 2022 Group of Companies Med Expert, LLC. All rights reserved.
ABSTRACT
The article summarizes the clinical recommendations for the diagnosis and treatment of children with coronavirus infection COVID019, which occurs against a background of various chronic somatic diseases. This protocol is based on the materials of many international reference documents, as well as the latest Ukrainian protocol for the detection and treatment of coronavirus infection COVID019 (Order No. 1227 of 05.20.2020). Aspects of the classification of severi0 ty and risk factors for the severe course of the disease are reflected, which include background somatic diseases requiring an individualized approach to treat0 ment. The diagnostic criteria for this infection are characterized, as well as the differences in the clinical symptoms of COVID019 in children and the clinical manifestations in adults. Separately, data are presented on the complication of childhood COVID019 infection, a multisystemic inflammatory syndrome. The peculiarity of this protocol is recommendations for the management of children with COVID019 infection, which occurs against a background of diseases of the cardiovascular system (congenital heart defects, pulmonary hypertension, cardiac arrhythmias and conduction disorders, etc.), respiratory diseases (bronchial asthma and bronchopulmonary dysplasia), rheumatic (juvenile arthritis, connective tissue diseases and systemic vasculitis with lung damage, vari0 ants of diseases requiring constant glucocorticoid therapy or occurring in the presence of diabetes mellitus) and other autoimmune diseases (autoimmune hepatitis, glomerulonephritis, especially with chronic liver or kidney failure). Recommendations are also given for the management of children with COVID019 concurrently with diseases of the kidneys and urinary system, endocrine diseases (diabetes mellitus type I, disorders of the thyroid and adrenal glands), onco0 logical and hematological diseases, including the immunosuppression states. © 2020 Group of Companies Med Expert, LLC. All right reserved.