G E Çelik1, G Karakaya2, A B Öztürk2, A Gelincik3, O Abadoğlu4, A Sin5, E Damadoğlu2, İ Yılmaz6, M Demirtürk3, B Dursun7, S K Özdemir6, S Çelikel8, P Değirmenci9, B Bozkurt10, Ö Göksel11, F Ö Erkekol7, Ö Aydın6, A B Kavut12, C Kırmaz9, F Kalpaklıoğlu12, S Büyüköztürk3, F Kalyoncu2. 1. Ankara University School of Medicine, Cebeci Research Hospital, Department of Chest Diseases, Division of Immunology and Allergy, Turkey. Electronic address: gulfemcelik@gmail.com. 2. Hacettepe University School of Medicine, Department of Chest Disease, Adult Allergy Unit, Turkey. 3. Istanbul University School of Medicine, Department of Internal Medicine, Division of Allergy, Turkey. 4. Cumhuriyet University School of Medicine, Department of Chest Diseases, Division of Immunology and Allergic Diseases, Turkey. 5. Ege University School of Medicine, Department of Internal Medicine, Division of Allergy and Clinical Immunology, Turkey. 6. Ankara University School of Medicine, Cebeci Research Hospital, Department of Chest Diseases, Division of Immunology and Allergy, Turkey. 7. Ataturk Chest Diseases and Thoracic Surgery, Training and Research Hospital, Turkey. 8. Gaziosmanpasa University, School of Medicine, Department of Pulmonary Diseases, Turkey. 9. Celal Bayar University School of Medicine, Department of Internal medicine, Division of Immunology and Allergy, Turkey. 10. Fatih University School of Medicine, Department of Chest Diseases, Division of Immunology and Allergy, Turkey. 11. Izmir Ataturk Training and Research Hospital, Turkey. 12. Kırıkkale University School of Medicine, Department of Chest Diseases, Division of Immunology and Allergic Diseases, Turkey.
Abstract
BACKGROUND: No data are available on the incidence of drug hypersensitivity (DH) reactions in outpatient settings of tertiary allergy/immunology clinics. Our aims were to document the frequency of outpatient hospital admissions due to DH reactions to allergy/immunology clinics in adults and the management of these reactions in real life. We also investigated whether drug allergy affected social and medical behaviours of the patients. METHODS: This multi-centre study was performed for one year with the participation of 11 out of 16 tertiary allergy/clinical immunology clinics in Turkey. The study group consisted of the patients with DH reactions. Results of a questionnaire including drug reactions and management were recorded. RESULTS: Among 54,863 patients, 1000 patients with DH were enrolled with a median of 2.1% of all admissions. In real life conditions, the majority of approaches were performed for finding safe alternatives (65.5%; 1102 out of 1683) with 11.7% positivity. Diagnostic procedures were positive in 27% (154/581) of the patients. The majority of the patients had higher VAS scores for anxiety. A total of 250 subjects (25%) reported that they delayed some medical procedures because of DH. CONCLUSION: Our results documented the frequency of admissions due to DH reactions to allergy/clinical immunology clinics for the first time. Although physicians mostly preferred to perform drug tests in order to find safe alternatives, considering the fact that DH was confirmed in 27% of the patients, use of diagnostic tests should be encouraged, if no contraindication exists in order to avoid mislabelling patients as DH.
BACKGROUND: No data are available on the incidence of drug hypersensitivity (DH) reactions in outpatient settings of tertiary allergy/immunology clinics. Our aims were to document the frequency of outpatient hospital admissions due to DH reactions to allergy/immunology clinics in adults and the management of these reactions in real life. We also investigated whether drug allergy affected social and medical behaviours of the patients. METHODS: This multi-centre study was performed for one year with the participation of 11 out of 16 tertiary allergy/clinical immunology clinics in Turkey. The study group consisted of the patients with DH reactions. Results of a questionnaire including drug reactions and management were recorded. RESULTS: Among 54,863 patients, 1000 patients with DH were enrolled with a median of 2.1% of all admissions. In real life conditions, the majority of approaches were performed for finding safe alternatives (65.5%; 1102 out of 1683) with 11.7% positivity. Diagnostic procedures were positive in 27% (154/581) of the patients. The majority of the patients had higher VAS scores for anxiety. A total of 250 subjects (25%) reported that they delayed some medical procedures because of DH. CONCLUSION: Our results documented the frequency of admissions due to DH reactions to allergy/clinical immunology clinics for the first time. Although physicians mostly preferred to perform drug tests in order to find safe alternatives, considering the fact that DH was confirmed in 27% of the patients, use of diagnostic tests should be encouraged, if no contraindication exists in order to avoid mislabelling patients as DH.
Authors: Martín Bedolla-Barajas; Cecilia Puente-Fernández; Miriam V Flores-Merino; Jaime Morales-Romero; Ma Victoria Domínguez-García Journal: Asia Pac Allergy Date: 2017-07-26