Subject(s)
Asthma , Drug Hypersensitivity , Drug-Related Side Effects and Adverse Reactions , Hypersensitivity , Asthma/drug therapy , Biological Factors , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/epidemiology , Drug Hypersensitivity/etiology , Humans , Hypersensitivity/diagnosis , Hypersensitivity/epidemiology , Hypersensitivity/etiologyABSTRACT
BACKGROUND: Suspicion of allergic drug reaction can cause important disturbances in the patient's life. OBJECTIVE: We evaluated in a prospective multicenter study the quality of life of patients who suffered a possible allergic drug reaction, and analyzed the effect of a drug allergy evaluation. METHODS: Patients (>18 years old) answered the specific questionnaire twice: before the drug allergy evaluation, and 1 month after it was completed. Statistics were performed using STATA. RESULTS: A total of 360 patients (240, 66.6% female; mean age, 45.4 years; standard deviation [SD], 15.6 years) completed the first questionnaire. After the evaluation, 150 of 346 patients (43.4%) were diagnosed as allergic to the drug (115 of 150 immediate; 35 of 150 delayed) and 196 of 346 patients (56.6%) as nonallergic. The mean value of the first questionnaire was 32.14 (SD, 11.84); patients with anaphylaxis, nonanaphylactic immediate reaction, with more than 1 drug reaction, or a chronic osteoarticular disease, had a statistically significant higher score in Q0 (worse quality of life). After the allergy study, the mean of the second questionnaire was 27.27 (SD, 9.96), showing a global improvement (P < .001). No statistically significant difference was found between drug allergic and non-drug allergic patients (P = .340); however, being >40 years old (P = .030), having a chronic osteoarticular disease (P = .003) and having more than 1 reaction to drugs (P < .001) were associated with a statistically significant worse quality of life after the evaluation. CONCLUSIONS: Having suffered anaphylaxis, more than 1 reported drug allergy or presenting a musculoskeletal disease are factors that worsen the quality of life. Quality of life improved significantly after completing a drug allergy evaluation.
Subject(s)
Drug Hypersensitivity/psychology , Quality of Life , Adult , Aged , Drug Hypersensitivity/diagnosis , Female , Humans , Male , Middle Aged , Spain , Surveys and QuestionnairesSubject(s)
Acetaminophen/adverse effects , Analgesics, Non-Narcotic/adverse effects , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/etiology , Acetaminophen/administration & dosage , Acetaminophen/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Analgesics, Non-Narcotic/administration & dosage , Analgesics, Non-Narcotic/immunology , Drug Hypersensitivity/immunology , Female , Humans , Male , Middle Aged , Severity of Illness Index , Skin Tests/methods , Young AdultABSTRACT
BACKGROUND: Penicillin G and V have the same betalactam ring. Penicillin V (phenoxymethylpenicillin) results from the substitution of the phenyl acetic acid of benzylpenicillin by the phenoxy methyl side chain. METHODS: Our patient was a 34-year-old man who experienced generalized urticaria after ingestion of Penicillin V. We performed skin prick tests and intradermal tests with a battery of betalactams including Penicillin V. We also determined specific IgE against penicillin V, penicillin G, amoxicillin, and ampicillin and performed a single-blind oral challenge with Penicillin V, amoxicillin, cefuroxime, and ceftazidime. RESULTS: The results of skin prick and intradermal tests with the betalactams included were negative. Specific IgE with betalactams was < 0.10 IU/L. The result of a single-blind oral challenge with Penicillin V was positive: 40 minutes after receiving 125 mg of Penicillin V, the patient presented generalized pruritus with hives on his back and chest. He tolerated oral administration of amoxicillin, cefuroxime, and ceftazidime. CONCLUSION: We report an exceptional case of sensitization to Penicillin V with negative results in the allergy workup. Diagnosis was based on a positive single-blind oral challenge result. The patient tolerated other betalactams. We provide a brief summary of the most relevant recent patents.
Subject(s)
Drug Hypersensitivity/diagnosis , Epitopes/metabolism , Penicillin V/metabolism , Urticaria/diagnosis , Administration, Oral , Adult , Animals , Drug Hypersensitivity/immunology , Humans , Immune Tolerance , Immunization , Immunoglobulin E/blood , Male , Patents as Topic , Penicillin V/immunology , Skin Tests , Urticaria/immunology , beta-Lactams/immunologyABSTRACT
BACKGROUND: Paracetamol (acetaminophen) is a widely used analgesic/antipyretic drug for which hypersensitivity reactions appear to be increasingly frequent. OBJECTIVE: We report the case of a woman who experienced several delayed selective reactions induced by paracetamol: fixed drug eruptions (FDEs) with typical features but an unusual distribution (hard palate and a maculopapular rash. METHODS: Skin tests: prick, intradermal and patch tests as well as a single-blind oral challenge test (OCT) were performed. RESULTS: Skin tests were negative. The OCT was necessary to confirm the diagnosis. Interestingly, the challenge test elicited an FDE-type lesion instead of a maculopapular rash. CONCLUSIONS: Our findings could reflect 2 different clinical patterns of delayed allergic reactions, or, more probably, the initial phase of a unique clinical entity that was stopped by the corticosteroids prescribed during the challenge. However, we were unable to confirm these hypotheses. The uncommon anatomical site of the lesions (hard palate) is noteworthy. Some relevant patents are also summarized in this paper.
