Drug hypersensitivity reactions in Asia: regional issues and challenges
Bernard-Yu-Hor THONG; Michaela LUCAS; Hye-Ryun KANG; Yoon-Seok CHANG; Philip-Hei LI; Min-Moon TANG; James YUN; Jie-Shen FOK; Byung-Keun KIM; Mizuho NAGAO; Iris RENGGANIS; Yi-Giien TSAI; Wen-Hung CHUNG; Masao YAMAGUCHI; Ticha RERKPATTANAPIPAT; Wasu KAMCHAISATIAN; Ting-Fan LEUNG; Ho-Joo YOON; Luo ZHANG; Amir-Hamzah-Abdul LATIFF; Takao FUJISAWA; Francis THIEN; Mariana-C CASTELLS; Pascal DEMOLY; Jiu-Yao WANG; Ruby PAWANKAR.
Asia Pacific Allergy
; (4): 8-2020.
Artículo
en Inglés
| WPRIM | ID: wpr-785457
There are geographical, regional, and ethnic differences in the phenotypes and endotypes of patients with drug hypersensitivity reactions (DHRs) in different parts of the world. In Asia, aspects of drug hypersensitivity of regional importance include IgE-mediated allergies and T-cell-mediated reactions, including severe cutaneous adverse reactions (SCARs), to beta-lactam antibiotics, antituberculous drugs, nonsteroidal anti-inflammatory drugs (NSAIDs) and radiocontrast agents. Delabeling of low-risk penicillin allergy using direct oral provocation tests without skin tests have been found to be useful where the drug plausibility of the index reaction is low. Genetic risk associations of relevance to Asia include human leucocyte antigen (HLA)-B*1502 with carbamazepine SCAR, and HLA-B*5801 with allopurinol SCAR in some Asian ethnic groups. There remains a lack of safe and accurate diagnostic tests for antituberculous drug allergy, other than relatively high-risk desensitization regimes to first-line antituberculous therapy. NSAID hypersensitivity is common among both adults and children in Asia, with regional differences in phenotype especially among adults. Low dose aspirin desensitization is an important therapeutic modality in individuals with cross-reactive NSAID hypersensitivity and coronary artery disease following percutaneous coronary intervention. Skin testing allows patients with radiocontrast media hypersensitivity to confirm the suspected agent and test for alternatives, especially when contrasted scans are needed for future monitoring of disease relapse or progression, especially cancers.
Asunto(s)
Adulto Niño Humanos Alopurinol Anafilaxia Antibacterianos Asia Pueblo Asiatico Aspirina Asma Carbamazepina Cicatriz Medios de Contraste Enfermedad de la Arteria Coronaria Pruebas Diagnósticas de Rutina Hipersensibilidad a las Drogas Etnicidad Hipersensibilidad Penicilinas Intervención Coronaria Percutánea Fenotipo Recurrencia Pruebas Cutáneas
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