Treating COVID-19: Review of Drug Hypersensitivity Reactions.

The disease caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ie, coronavirus disease 2019 (COVID-19), has become a global pandemic since it was first reported in Wuhan, China in December 2019. Its severe clinical manifestations, which often necessitate admission to intensive care units, and high mortality rate represent a therapeutic challenge for the medical community. To date, no drugs have been approved for its treatment, and various therapeutic options are being assayed to address the pathophysiological processes underlying the clinical manifestations experienced by patients. New and old drugs administered as monotherapy or in combination to immunologically compromised patients may favor the development of adverse drug reactions, including drug hypersensitivity reactions, which must be identified and managed accordingly. Given the lack of herd immunity and the high rate of viral contagion, new cases are expected to emerge in the coming months. Thus, the probability of more adverse reactions or even new clinical manifestations may increase in parallel. Allergists must receive updated information on these treatments, as well as on the management of possible drug hypersensitivity reactions.

Treating COVID-19: review of drug hypersensitivity reactions

The disease caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ie, coronavirus disease 2019 (COVID-19), has become a global pandemic since it was first reported in Wuhan, China in December 2019. Its severe clinical manifestations, which often necessitate admission to intensive care units, and high mortality rate represent a therapeutic challenge for the medical community. To date, no drugs have been approved for its treatment, and various therapeutic options are being assayed to address the pathophysiological processes underlying the clinical manifestations experienced by patients. New and old drugs administered as monotherapy or in combination to immunologically compromised patients may favor the development of adverse drug reactions, including drug hypersensitivity reactions, which must be identified and managed accordingly. Given the lack of herd immunity and the high rate of viral contagion, new cases are expected to emerge in the coming months. Thus, the probability of more adverse reactions or even new clinical manifestations may increase in parallel. Allergists must receive updated information on these treatments, as well as on the management of possible drug hypersensitivity reactions

La enfermedad causada por el nuevo Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), Coronavirus Disease 2019 (COVID-19), se ha expandido en forma de pandemia global desde su inicio en Wuhan (China) en diciembre de 2019. La aparición de formas clínicas graves asociadas a la necesidad de ingreso en unidades de Cuidados Intensivos, con un alto índice de letalidad, ha supuesto un reto terapéutico para la comunidad médica. Actualmente no hay ningún fármaco aprobado para su tratamiento y se están ensayando diversas opciones terapéuticas para abordar los procesos fisiopatológicos responsables de las manifestaciones clínicas que experimentan los pacientes. Tanto el uso de viejos como de nuevos principios activos como tratamiento único o en combinación, en pacientes inmunológicamente comprometidos, puede favorecer la aparición de efectos adversos, entre ellos reacciones de hipersensibilidad de mecanismo inmunológico, que habrá que saber identificar y manejar correctamente. Es de prever que, en los próximos meses, dada la falta de inmunidad comunitaria y el elevado índice de contagiosidad del virus, sigan surgiendo nuevos casos y, con ello, la probabilidad de que aparezcan más reacciones adversas o incluso nuevas manifestaciones clínicas. Es importante que los alergólogos estén al día de las opciones terapéuticas que se están utilizando, así como de sus posibles reacciones adversas, inclusive reacciones de hipersensibilidad y cómo manejarlas

Recurrent drug-induced liver injury with cetirizine and amoxicillin-clavulanate potassium

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Esophageal dysfunction and immunological changes induced by grass sublingual immunotherapy.

Sublingual immunotherapy frequently causes local oropharyngeal adverse events which are usually of mild severity, and tend to be self-limited and disappear within the first weeks of therapy. The mechanism of action involves changes in the specific humoral response to allergens, with increases in allergen-specific immunoglobulin G4 (IgG4) and blunting of the seasonal increase in allergen-specific IgE. We describe the case of a 25-year-old man diagnosed with grass pollen induced allergic rhinoconjunctivitis, who was treated with a lyophilisate of Phleum pratense by sublingual route. After 5 weeks of therapy he developed repeatedly intense symptoms of esophageal dysfunction immediately after the administration. Symptoms recurred every day, subsided in some hours without treatment and disappeared with the termination of therapy. The episode coincided with a marked elevation of total and specific IgE. The immunological changes gradually declined during the three years of follow up. The reported case suggests the need to evaluate the role of the immunological changes detected after the first weeks of sublingual therapy with Phleum pratense, in the induction of esophageal disorders.