Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America

Maria Torres 1, 2, * Antonino Romano 3, 4 G. Celik 5 P. Demoly 6 D. A. Khan 7 E. Macy 8 M. Park 9 K. Blumenthal 10 W. Aberer 11 M. Castells 12 A. Barbaud 13, 14 C. Mayorga 1 P. Bonadonna 15
* Auteur correspondant
1 National Network ARADyAL - Allergy Unit [Malaga, Spain]
2 BIONAND - The Andalusian Center for Nanomedicine and Biotechnology
3 Allergy Unit [Italy]
4 IRCCS - Istituto di Ricovero e Cura a Carattere Scientifico [Troina, Italy]
5 Department of Chest Diseases [Ankara, Turkey]
6 Equipe EPAR - Épidémiologie des maladies Allergiques et Respiratoires
iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
7 Department of Internal Medicine [Dallas, TX, USA]
8 Kaiser Permanente Health Care Program [San Diego, CA, USA]
9 Division of Allergic Diseases [Rochester, MN, USA]
10 Department of Medicine - Division of Rheumatology, Allergy and Immunology [Boston, MA, USA]
11 Department of Dermatology [Graz, Austria]
12 Division of Rheumatology, Immunology and Allergy [Boston, MSA, USA]
13 Service de dermatologie et allergologie
14 USPC - Université Sorbonne Paris Cité
15 Allergy Unit [Verona, Italy]
Abstract : Abstract Drug hypersensitivity reactions (DHRs) affect an unknown proportion of the general population, and are an important public health problem due to their potential to cause life-threatening anaphylaxis and rare severe cutaneous allergic reactions. DHR evaluations are frequently needed in both ambulatory and hospital settings and have a complex diagnosis that requires a detailed clinical history and other tests that may include in vitro tests and in vivo procedures such as skin tests and drug provocation tests. Although over the years both European and U.S. experts have published statements on general procedures for evaluating DHRs, a substantial discordance in their daily management exists. In this review, we highlight both the differences and the similarities between the European and U.S. perspectives. While a general consensus exists on the importance of skin tests for evaluating DHRs, concordance between Americans and Europeans exists solely regarding their use in immediate reactions and the fact that a confirmation of a presumptive diagnosis by drug provocation tests is often the only reliable way to establish a diagnosis. Finally, great heterogeneity exists in the application of in vitro tests, which require further study to be well validated.
Keywords : Sensitization IgE T-cells Drug provocation test Drug Hypersensitivity Allergy Diagnosis Skin test In vitro test Europe United States
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Article dans une revue
Clinical and Translational Allergy, BioMed Central, 2016, 7 (1), pp.7. 〈10.1186/s13601-017-0144-0〉
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Maria Torres, Antonino Romano, G. Celik, P. Demoly, D. A. Khan, et al.. Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America. Clinical and Translational Allergy, BioMed Central, 2016, 7 (1), pp.7. 〈10.1186/s13601-017-0144-0〉. 〈inserm-01488601〉

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