Prevalence Of Drug Allergy Research Articles

A Marked Eosinophilic Infiltration in Mucosa Could Be a Better Predictive Factor for Intractable Non-Esophageal Eosinophilic Gastrointestinal Disorders

Introduction: Non-esophageal eosinophilic gastrointestinal disorders (non-EoE EGIDs) are rare, but their prevalence has recently increased. Although it has been reported that one-half of patients with non-EoE EGIDs have intractable clinical courses, their clinical features are not fully understood. Methods: This is a multicenter retrospective study in which 10 institutions in Japan participated. Clinical databases from January 1998 to December 2020 were reviewed to identify patients with non-EoE EGIDs. A total of 44 patients were identified; they were divided into two groups based on their clinical course: an intractable group and a non-intractable group. The clinical features were compared between the two groups by a logistic regression analysis. Remarkable eosinophilic infiltration (REI) was defined histologically when the maximal counts of mucosal eosinophils reached a threshold level in the respective area of biopsy. Results: Prevalence of drug allergy and eosinophil counts more than 500/μL (EOS), vomiting symptoms, abnormalities of the stomach, duodenum, and jejunum on computed tomography (upper gastrointestinal abnormality on computed tomography [UACT]), and REI were significantly different between the two groups. Among the factors that were potentially associated with an intractable clinical course, logistic regression revealed that REI, EOS, and UACT were significant factors. Based on an analysis of the area under the receiver operator characteristic curve, a combination of REI and EOS had the lowest Akaike’s information criterion, indicating the best model to predict an intractable clinical course. Conclusions: REI may predict an intractable course in patients with non-EoE EGIDs. In addition, the combination of REI and EOS was a better predictor than REI alone.

Prevalence of drug allergy in South Australia.

Drug allergy is commonly reported in patient notes and electronic health records. The prevalence of self-reported drug allergy in the general Australian population has not previously been studied. To investigate the prevalence of self-reported drug allergy in the general adult population in South Australia. We surveyed a representative sample of the South Australian adult population regarding their own perception of drug allergy, including drug type and severity, as well as the use of medical alert devices. Data were weighted to correspond to age and sex of the South Australian population. Twenty-two percent of adults in South Australia consider themselves allergic to one or more drugs: 9.3% declared themselves to be allergic to penicillin, 5% to an antibiotic other than penicillin and 13% to one or more antibiotics. Drug allergy and penicillin allergy was significantly more prevalent in females and increased with age. Thirteen percent of those with an antibiotic allergy reported a severe reaction, of whom 27% wore a medical notification device. Of those allergic to penicillin, 75% had their index reaction more than 10 years ago and did not report severe features. Self-reported drug allergy is common in the general population, as it is in medical clinic and hospital populations. The majority of those reporting penicillin allergy would be considered low-risk and suitable for de-labelling procedures.

Evaluation of Frequency and Characteristics of Drug Allergy in Pediatric Patients with Cystic Fibrosis.

Background: Previous studies reported that the prevalence of drug allergy is higher in patients with cystic fibrosis (CF) than in the general population. It is important to exclude or confirm the drug allergy diagnosis with detailed allergic evaluation for preventing drug allergy overdiagnosis. Our study aims to determine the actual frequency of drug allergy proven by diagnostic tests in children with CF and to compare it with the control group. Methods: Patients diagnosed with CF who were followed up in the Pediatric Pulmonology Clinic were included in the study group. Children with similar gender and age characteristics who did not have any chronic diseases and who applied to the Pediatric Polyclinics were included in the control group. We reviewed the medical data of patients with CF. Also, we evaluated the parents of the patients via phone conversation and/or during the control of the outpatient clinic and questioned them in terms of drug allergy. In addition, we assessed those with suspected drug allergies in the pediatric allergy clinic for diagnostic tests and compared it to the control group. Results: CF patients (n = 44) and control group (n = 100) were included in the study. Only 1 patient (2.2%) out of the 44 patients in the study group had a suspicion of drug-related hypersensitivity history. In the control group, 1 patient had a history of rash, provocation test was performed to rule out drug hypersensitivity reaction, and it was evaluated as a negative result. Conclusions: The result of our study showed that the frequency of drug allergy in children diagnosed with CF was not different from the control group. However, it will be useful to confirm the data of pediatric patients with CF in larger groups. In the presence of suspicion of drug allergy, a diagnostic evaluation can prevent unnecessary drug allergy diagnoses.

Parental‐reported drug allergy in 6‐ to 9‐yr‐old urban schoolchildren

Epidemiologic studies about the prevalence of adverse drug reactions in children are scarce compared to reports in adults. To assess the prevalence of parental-reported drug allergy in 6- to 9-yr-old urban school children, we performed a cross-sectional study of 6- to 9-yr-old urban children from the eastern Black Sea region of Turkey during the year 2004, using a self-administered questionnaire by parents. Response rate was 81.6% (2855/3500). The prevalence of parental-reported drug allergy was 2.8% (81/2855). The most common parental-reported drugs were penicillins and other beta-lactams (59.3%), trimethoprim-sulfamethoxazole (11.1%), and acetylsalicylic acid and other non-steroidal anti-inflammatory drugs (NSAIDs) (9.9%). The most commonly reported clinical manifestations were cutaneous (n = 76, 93.8%) followed by gastrointestinal (n = 17, 21%) symptoms. In 19 (23.5%) children, the reaction involved more than one organ system. Of these 19 children, 14 used beta-lactams. Systemic reactions were not reported with NSAIDs. Medications were taken by mouth in 88.9% of the reactions. Most of the reported allergic reactions occurred in the first day of treatment (61.7%). The reported time to reaction after the last intake of the drug was <2 h in 35 (43.2%) children and 2-24 h in 45 (55.6%). Oral reactions occurred later than reactions to parentally administered drugs. Parents of 58 children (71.6%) reported that they completely avoided the suspected culprit drug following the reaction. Relapse occurred after re-administration of the drug in 21 (25.9%) children. A diagnostic approach for drug allergy was not undertaken in any of the children. This study may provide some information about the prevalence of drug allergy, although it is based on parental perception and results are unlikely to conform well to true prevalence.

Prevalence of Drug Adverse Reactions in Out-Patients

RATIONALE: Studies of epidemiology of drug reactions in patients attending Allergy Centers are scarce. The prevalence of drug allergy in out-patients has been analysed. METHODS: The files of 9 067 patients have been reviewed. Clinical presentation and suspected drugs registered. Skin tests with the group of drug incremated have been done by prick and intradermal techniques in progressive concentrations when prick were negative informed consent was obtained from all the patients. Specific IgE or leucotrienes release has been done in cases these techniques are available. RESULTS: 448 (4,9%) out of 9 067 patients reported one or more drug adverse reactions: (females 69,7%, males 30,3%). 90% of the patients reported urticaria/angiodema and 10% rhinitis and/or asthma. NSAIDS were implied in 63,6% of the patients, ß-lactams in 34,2%, local anesthetics in 4,7%. Associations of reactions to NSAIDS and ß-lactams were frequent (22,3%) other drug less implied were sulfa drugs, quinolones, macrolides, ACE inhibitors, angiotensin II blockers, statins, corticosteroids, vitamines, allopurinol, tetracyclin, gentamycin, furadantine, curarisers, tramadol, ranitidin, thyocholchycosid, fibrates, fluconazol. Specific IgE and CAST (leucotrienes release) were positive only in less than 50% of the cases. CONCLUSIONS: NSAIDS and ß-lactams are the more frequent cause of adverse reactions in out-patients clinical history, skin tests step by step are the more practical first diagnostic approach of drug allergy in out-patients.

Allergie à la pyostacine : à propos d’un cas

We report the case of woman with generalized urticaria, dyspnoea and hypotension after ingestion of pristinamycin. The patient had cystic fibrosis, with Pseudomonas aeruginosa bronchial colonization. A prick test with pristinamycin was strongly positive at a 1/10,000 dilution, which we considered to be evidence of an IgE-mediated reaction. The prevalence of drug allergy is greater in patients with cystic fibrosis than in the general population; multiple courses of antibiotics and the association of different antibiotics are the principal risk factors for allergic reactions in these patients. In patients allergic to pristinamycin, the digestive tract is most often the organ involved; anaphylaxis is rare. Although allergy to pristinamycin is rare, that possibility must be kept in mind when this drug is given to patients with a history of frequent and multiple antibiotic treatment.

The prevalence of allergic diseases among health care workers (HCW) in the South of Russia

Rationale The prevalence of allergic diseases among HCW may be influenced by unique occupational exposures. Methods A questionnaire was completed by 430 HCW: 240 physicians (47.4%) and 226 nurses (52.6%) from five regions of Krasnodar and Volgograd, average age 42 ± 5.0 years. Results The prevalence of allergic diseases by history was 44.1% (49.5% in physicians, 39.3% in nurses). Asthma was present in 4.9%, seasonal allergic rhinitis in 12%, perennial allergic rhinitis in 12.5%, urticaria in 13.4%, angioedema in 5.8%, atopic dermatitis in 7.9% and drug allergy in 14.9%, the latter noted in 20.5% of physicians and in 15.4% of nurses. A clinical history of allergy to house dust was noted in 19.1%, to pillow feathers in 8.4%, to cat in 5.8%, to dog in 3.7%, to tree pollen in 13.1%, to grass pollen in 8.4%, to ragweed pollen in 8.4% and to food in 25.7%. 20% of those studied revealed the first symptoms of allergic disease after they had started working, the prevalence depending on the length of work experience: 6.7% of HCW manifested allergic disease one year after the start of work, whereas 47% required 7 or more years before allergic disease was apparent. Conclusions The prevalence of asthma and allergic rhinitis among HCW did not differ from the general population, while the prevalence of drug allergy in health care workers was greater, suggesting that HCW may develop more drug allergy due to different patterns of allergen exposure than in the general population.

Increased rates of drug allergy in inflammatory bowel disease (IBD) patients compared to irritable bowel syndrome (IBS) patients and normal controls

Background and Aims: Drug allergy (rash, angioedema, anaphylactic, anaphylactoid reactions) is a frequently encountered clinical problem, and published reports suggest that it is present in up to 20% of hospitalized patients. The rate of drug allergy among patients with 1BD (Crohn's disease (CD), ulcerative colitis (UC)) has not been previously described. We hypothesized that adult patients with chronic gut inflammation would have increased rates of drug allergy compared to controls. Methods: Retrospective observational analysis was performed on all 1BD patients followed at a tertiary referral center. All intake visits were reviewed for histories of drug allergy, defined as emergence of rash, angnoedema, anaphytactic/ anaphylactoid reaction following challenge with the offending agent. Demographic information regarding patients as well as classes of agents inducing allergic reactions were recorded, as was the duration of the IBD. Controls included patients with irritable bowel syndrome as well as healthy volunteers without clinical evidence of gastrointestinal disease. Results: Records of 410 IBD patients (297 CD, 107 UC, 6 indeterminate colitis) were reviewed, as weft as 230 control patients (IBS 50, normal 180). 33.2% of IBD patients and 19% of controls demonstrated drug allergy ( p = < 0.001 Chi-square). There was no difference between the prevalence of drug allergy between CD and UC patients. The duration of disease did not impact on the prevalence of drug allergy. There were significantly more female IBD patients with drug allergy when compared to males (36% vs. 25%; p = < 0 . 0 3 ) which corresponded with an increased rate of drug allergy noted in the female control population. The classes of drugs associated with allergic reactions in IBD patients included penicillin (13.9%), sulfa (8.3%), narcotics (7.1%). The prevalence of antibiotic allergy in the IBD patients was 22% compared with 11% of controls (p = <O.001). Conclusions: The prevalence of drag allergy is significantly higher in patients with IBD compared to patients with IBS or healthy volunteers. Female IBD patients have a higher prevalence of allergic reactions compared to males, but there is no difference in the prevalence of the reactions between UC and CD Drug allergnc IBD patients are a commonly encountered phenotype which pose added clinical challenges in management.

Allergic Disorders in Systemic Lupus Erythematosus

Allergic disorders commonly occur in patients with systemic lupus erythematosus (SLE) and allergies to some drugs may occasionally be related to disease flares. We evaluated the prevalence of several types of allergy in 132 patients with SLE and their families and compared the SLE patients with a control group of 66 patients with non-lupus disorders. Total IgE levels were tested in 117 SLE patients and 61 controls. Eighty-three of the 132 SLE patients (63%) had a history of at least one type of allergic disorder. This prevalence was significantly higher (P < 0.0001) than that of the control group (20 of 66 controls). The prevalence of drug allergy (38% vs. 17%; P < 0.005), skin allergy (36% vs. 17%; P < 0.01) and insect allergy (14% vs. 2%; P < 0.02) were significantly higher in SLE patients when compared with controls. Family members of SLE patients had an increased prevalence of at least one type of allergy (55% vs. 24%; P < 0.0001), allergic rhinitis (30% vs. 14%; P < 0.02), asthma (25% vs. 9% P < 0.02), and both rhinitis or asthma (44% vs. 20%; P < or = 0.002). The presence of allergy both in the patient and in the family was more frequent in SLE patients than controls (42% vs. 15%; P < 0.001). We found no differences in total IgE levels between the two groups. Drug, skin and insect allergies were particularly frequent in SLE patients. We also found a high prevalence of rhinitis and asthma in their families.