본문 바로가기
KERD
논문KCI 등재

약물 알레르기의 진단

Update on the diagnosis of drug allergy

2

조회

0

다운로드

8

인용

0

참고문헌

키워드

주제분류내과학

초록

Hypersensitivity reactions to drugs are classified as immediate or nonimmediate reactions depending on the basis of time of appearance of reactions. Clinical and immunological studies suggest that immediate reaction is IgE-mediated and nonimmediate as type-IV (cell-mediated) reaction. For the evaluation of drug allergy, the patient's history is fundamental; the allergologic examination includes in-vivo and in-vitro tests selected on the basis of the clinical features. Prick, patch, and intradermal tests are the most readily available forms of allergy testing. However, there are some changes in the diagnostic evaluation of allergic reactions to beta-lactams, iodinated contrast media and local anaesthetics over the last several years. In immediate reactions, the sensitivity of skin testing and immunoassay is decreasing and for nonimmediated reactions, skin testing appears to be less sensitive than previous results. Drug provocation test is still the gold standard for identification of an causative drugs. The new diagnostic tools, such as the basophil activation test and the lymphocyte activation test, have been developed and are under validation. Based on the literature, the proposed algorithm may safely and rapidly distinguish between immediate-type and immediate drug reactions. This review provides an update to European Network for Drug Allergy (ENDA) document that gave the guidelines for the evaluation of drug allergy. The diagnosis of drug allergy needs to be standardized.

Abstract

Hypersensitivity reactions to drugs are classified as immediate or nonimmediate reactions depending on the basis of time of appearance of reactions. Clinical and immunological studies suggest that immediate reaction is IgE-mediated and nonimmediate as type-IV (cell-mediated) reaction. For the evaluation of drug allergy, the patient's history is fundamental; the allergologic examination includes in-vivo and in-vitro tests selected on the basis of the clinical features. Prick, patch, and intradermal tests are the most readily available forms of allergy testing. However, there are some changes in the diagnostic evaluation of allergic reactions to beta-lactams, iodinated contrast media and local anaesthetics over the last several years. In immediate reactions, the sensitivity of skin testing and immunoassay is decreasing and for nonimmediated reactions, skin testing appears to be less sensitive than previous results. Drug provocation test is still the gold standard for identification of an causative drugs. The new diagnostic tools, such as the basophil activation test and the lymphocyte activation test, have been developed and are under validation. Based on the literature, the proposed algorithm may safely and rapidly distinguish between immediate-type and immediate drug reactions. This review provides an update to European Network for Drug Allergy (ENDA) document that gave the guidelines for the evaluation of drug allergy. The diagnosis of drug allergy needs to be standardized.

참고문헌 (50)

  1. Johansson SG, "Revised nomenclature for allergy for global use:Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003", J Allergy Clin Immunol, 113, pp.832~836 (2004)
  2. Pichler WJ, "Delayed drug hypersensitivity reactions", Ann Intern Med, 139, pp.683~693 (2003)
  3. Bousquet PJ, "Drug allergy and hypersensitivity: still a hot topic", Allergy, 64, pp.179~182 (2009)
  4. Bousquet PJ, "Pharmacovigilance of drug allergy and hypersensitivity using the ENDA-DAHD database and the GALEN platform. The Galenda project", Allergy, 64, pp.194~203 (2009)
  5. Demoly P, "Drug hypersensitivity questionnaire", Allergy, 54, pp.999~1003 (1999)
  6. Romano A, "Recent advances in the diagnosis of drug allergy", Curr Opin Allergy Clin Immuno, 7, pp.299~303 (2007)
  7. Adkinson NF, "Middleton's Allergy: Principles and Practice, 7th Edition", pp.1216~1219, Elsevier Inc
  8. Blanca M, "Continued need of appropriate betalactam- derived skin test reagents for the management of allergy to betalactams", Clin Exp Allergy, 37, pp.166~173 (2007)
  9. Macy E, "Penicillin skin testing in pregnant women with a history of penicillin allergy and group B streptococcus colonization", Ann Allergy Asthma Immunol, 97, pp.164~168 (2006)
  10. Wong BB, "Clinical history as a predictor of penicillin skin test outcome", Ann Allergy Asthma Immunol, 97, pp.169~174 (2006)
  11. Blanca M, "Update on the evaluation of hypersensitivity reactions to betalactams", Allergy, 64, pp.183~193 (2009)
  12. Levine BB, "Studies of the mechanism of the formation of the penicillin antigen III. The N(D-(benzylpenicilloyl)) group as an antigenic determinant responsible for hypersensitivity to penicillin G", J Exp Med, 114, pp.875~ (1961)
  13. Rodriguez-Bada JL, "Skin testing for immediate hypersensitivity to betalactams: comparison between two commercial kits", Allergy, 61, pp.947~951 (2006)
  14. Romano A, "A comparison of the performance of two penicillin reagent kits in the diagnosis of b-lactam hypersensitivity", Allergy, 62, pp.53~58 (2007)
  15. Romano A, "Benzylpenicillin skin testing is still important in diagnosing immediate hypersensitivity reactions to penicillins", Allergy, 64, pp.249~253 (2009)
  16. Blanca M, "Allergy to amoxicillin with good tolerance to other penicillins. Study of the incidence in patients allergic to betalactams", Clin Exp Allergy, 20, pp.475~481 (1990)
  17. Torres MJ, "Diagnostic evaluation of a large group of patients with immediate allergy to penicillins: the role of skin testing", Allergy, 56, pp.850~856 (2001)
  18. Jost BC, "Elective penicillin skin testing in a pediatric outpatient setting", Ann Allergy Asthma Immunol, 97, pp.807~812 (2006)
  19. Antunez C, "Immediate allergic reactions to cephalosporins: Evaluation of crossreactivity with a panel of penicillins and cephalosporins", J Allergy Clin Immunol, 117, pp.404~410 (2006)
  20. Romano A, "Diagnosing immediate reactions to cephalosporins", Clin Exp Allergy, 35, pp.1234~1242 (2005)
  21. Parker PJ, "Penicillin resensitization among hospitalized patients", J Allergy Clin Immunol, 88, pp.213~217 (1991)
  22. Goldberg A, "Skin testing and oral penicillin challenge in patients with a history of remote penicillin allergy", Ann Allergy Asthma Immunol, 100, pp.37~43 (2008)
  23. Co Minh HB, "Systemic reactions during skin tests with beta- lactams: a risk factor analysis", J Allergy Clin mmunol, 117, pp.466~468 (2006)
  24. Torres MJ, "Diagnosis of immediate allergic reactions to beta-lactam antibiotics", Allergy, 58, pp.961~972 (2003)
  25. Blanca M, "Clinical evaluation of Pharmacia CAP System RAST FEIA amoxicilloyl and benzylpenicilloyl in patients with penicillin allergy", Allergy, 56, pp.862~870 (2001)
  26. Fontaine C, "Relevance of the determination of serumspecific IgE antibodies in the diagnosis of immediate betalactam allergy", Allergy, 62, pp.47~52 (2007)
  27. Sanz ML, "Flow cytometric basophil activation test by detection of CD63 expression in patients with immediate- type reactions to betalactam antibiotics", Clin Exp Allergy, 32, pp.277~286 (2002)
  28. Torres MJ, "The diagnostic interpretation of basophil activation test in immediate allergic reactions to betalactams", Clin Exp Allergy, 34, pp.1768~1775 (2004)
  29. Messaad D, "Drug provocation tests in patients with a history suggesting an immediate drug hypersensitivity reaction", Ann Intern Med, 140, pp.1001~1006 (2004)
  30. Bousquet PJ, "Oral challenges are needed in the diagnosis of beta-lactam hypersensitivity", Clin Exp Allergy, 38, pp.185~190 (2008)
  31. Perez-Inestrosa E, "Cephalosporin chemical reactivity and its immunological implications", Curr Opin Allergy Clin mmunol, 5, pp.323~330 (2005)
  32. Romano A, "Immediate allergic reactions to cephalosporins: cross-reactivity and selective responses", J Allergy Clin Immunol, 106, pp.1177~1183 (2000)
  33. Frumin J, "Allergic Cross-Sensitivity Between Penicillin, Carbapenem, and Monobactam Antibiotics: What Are the Chances?", Ann Pharmacother (2009)
  34. Romano A, "Imipenem in patients with immediate hypersensitivity to penicillins", N Engl J Med, 354, pp.2835~2837 (2006)
  35. Cohen AD, "Which intercurrent infections are associated with maculopapular cutaneous drug reactions? A case-control study", IntJDermatol, 40, pp.41~44 (2001)
  36. Yawalkar N, "Infiltration of cytotoxic T cells in drug-induced cutaneous eruptions", Clin Exp Allergy, 30, pp.847~855 (2000)
  37. Padial A, "Non-immediate reactions to beta-lactams: diagnostic value of skin testing and drug provocation test", Clin Exp Allergy, 38, pp.822~828 (2008)
  38. Blanca-López N, "Skin testing and drug provocation tests in the diagnosis of non-immediate reactions to aminopenicillins in children", Allergy, 64, pp.229~233 (2009)
  39. Lammintausta K, "The usefulness of skin tests to prove drug hypersensitivity", Br J Dermatol, 152, pp.968~974 (2005)
  40. Romano A, "Diagnosing nonimmediate reactions to penicillins by in vivo tests", Int Arch Allergy Immunol, 129, pp.169~174 (2002)
  41. Rosso R, "Very delayed reactions to β-lactam antibiotics", Contact Dermat, 42, pp.293~295 (2000)
  42. Padovan E, "Penicilloyl peptides are recognized as T cell antigenic determinants in penicillin allergy", Eur J Immunol, 27, pp.1303~1307 (1997)
  43. Mauri-Hellweg D, "Crossreactivity of T cell lines and clones to beta-lactam antibiotics", J Immunol, 157, pp.1071~1079 (1996)
  44. Trcka J, "Aminopenicillin-induced exanthema allows treatment with certain cephalosporins or phenoxymethyl penicillin", J Antimicrob Chemother, 60, pp.107~111 (2007)
  45. Fisher M M, "Alleged allergy to local anaesthetics", Anaesth Intensive Care, 25, pp.611~614 (1997)
  46. Gall H, "Adverse reactions to local anesthetics: analysis of 197 cases", J Allergy Clin Immunol, 97, pp.933~937 (1996)
  47. Thyssen JP, "Hypersensitivity to local anaesthetics - update and proposal of evaluation algorithm", Contact Dermatitis, 59, pp.69~78 (2008)
  48. Guéant-Rodríguez RM, "Hypersensitivity reactions to iodinated contrast media", Curr Pharm Des, 12, pp.3359~3372 (2006)
  49. Kanny G, "T cell-mediated reactions to iodinated contrast media: Evaluation by skin andl ymphocyte activation tests", J Allergy Clin Immunol, 115, pp.179~185 (2005)
  50. Kvedariene V, "Diagnosis of iodinated contrast media hypersensitivity: results of a 6-year period", Clin Exp Allergy, 36, pp.1072~1077 (2006)

관련 논문AI추천

약물알레르기 검사의 시행과 해석: 전문가 의견서강혜련, 권재우, 권혁수, 김민혜, 김세훈, 김태범, 박해심, 반가영, 서동인, 송우정, 신유섭, 양민석, 이병재, 이애영, 이정민, 임경환, 정재우, 조상헌, 대한천식알레르기학회 표준화위원회대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2017 · 제5권 제5호Current practice for diagnosing immediate drug hypersensitivity reactions in KoreaMin-Suk Yang, Sang-Heon Cho, Sung-Yoon Kang, Woo-Jung Song대한내과학회 · The Korean Journal of Internal Medicine2021 · 제36권 제1호약물알레르기검사의 실태에 관한 설문조사강혜련, 고영일, 김세훈, 김정은, 김주희, 김태범, 박중원, 박창한, 손성욱, 예영민, 오미정, 이상록, 이소희, 정재우, 조영주대한천식알레르기학회 · 천식 및 알레르기2011 · 제31권 제4호항생제 약물알레르기의 진단과 관리김주희대한내과학회 · 대한내과학회지2021 · 제96권 제4호약물과민반응 환자에서 탈감작요법 적용강혜련, 윤정은, 정지웅대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2023 · 제11권 제2호사용 전 베타락탐 항생제 피부시험의 유용성에 대한 전문가 의견강혜련, 김성렬, 김세훈, 김수정, 박종숙, 박혜정, 서동인, 심다운, 양민석, 이재현, 이화영, 정재우, 최미라대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2022 · 제10권 제1호

이 간행물의 다른 논문 (12건)