P J Bousquet1, V Kvedariene, H-B Co-Minh, P Martins, M Rongier, B Arnoux, P Demoly. 1. Exploration des Allergies, Service des Maladies Respiratoires, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier; INSERM U454-IFR3, Hôpital Arnaud de Villeneuve, Montpellier, France.
Abstract
BACKGROUND: beta-lactam hypersensitivity reactions are classified as immediate or nonimmediate. Diagnosis is usually based upon skin tests and provocation challenges. OBJECTIVE: The time course of the reactions in proven beta-lactam hypersensitivities was studied and then correlated with the symptoms to determine the relationship between the clinical presentations and the time course. METHOD: All of the patients who consulted between 1996 and 2004 for a suspected beta-lactam hypersensitivity reaction were studied. Two hundred and ten patients with a proven hypersensitivity reaction diagnosed according to the European Network on Drug Allergy were included in the present study. RESULTS: Of the patients, 36.7% had urticaria as a single symptom, 19.1% anaphylaxis without shock, 17.6% anaphylactic shock and 19.1% maculopapular exanthema. Anaphylactic shock and anaphylaxis mostly occurred within 1 h after drug administration. Exanthema mainly occurred after 24 h. Urticaria as a single symptom occurred at any time. A firm diagnosis was determined using immediate-reading skin prick (10.0%) and intradermal tests (38.1%), late-reading skin tests (19.1%) or provocation tests (32.9%). CONCLUSION AND CLINICAL IMPLICATION: Depending on the time course of the reaction, three clinical groups were identified: anaphylaxis and anaphylactic shock (immediate reaction); maculopapular exanthema (late reaction) as well as urticaria (immediate and late reaction).
BACKGROUND: beta-lactam hypersensitivity reactions are classified as immediate or nonimmediate. Diagnosis is usually based upon skin tests and provocation challenges. OBJECTIVE: The time course of the reactions in proven beta-lactam hypersensitivities was studied and then correlated with the symptoms to determine the relationship between the clinical presentations and the time course. METHOD: All of the patients who consulted between 1996 and 2004 for a suspected beta-lactam hypersensitivity reaction were studied. Two hundred and ten patients with a proven hypersensitivity reaction diagnosed according to the European Network on Drug Allergy were included in the present study. RESULTS: Of the patients, 36.7% had urticaria as a single symptom, 19.1% anaphylaxis without shock, 17.6% anaphylactic shock and 19.1% maculopapular exanthema. Anaphylactic shock and anaphylaxis mostly occurred within 1 h after drug administration. Exanthema mainly occurred after 24 h. Urticaria as a single symptom occurred at any time. A firm diagnosis was determined using immediate-reading skin prick (10.0%) and intradermal tests (38.1%), late-reading skin tests (19.1%) or provocation tests (32.9%). CONCLUSION AND CLINICAL IMPLICATION: Depending on the time course of the reaction, three clinical groups were identified: anaphylaxis and anaphylactic shock (immediate reaction); maculopapular exanthema (late reaction) as well as urticaria (immediate and late reaction).
Authors: W Egner; M Helbert; R Sargur; K Swallow; N Harper; T Garcez; S Savic; L Savic; E Eren Journal: Clin Exp Immunol Date: 2017-03-13 Impact factor: 4.330
Authors: Khaled H Mahmoud; Abdullateef A Alzolibani; Zafar Rasheed; Yasser Farouk; Ghada Bin Saif; Ahmad A Al Robaee Journal: Int J Appl Basic Med Res Date: 2016 Oct-Dec