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Torres MJ, Romano A, Celik G, et al. Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America. Clin Transl Allergy. 2017;7:7doi: 10.1186/s13601-017-0144-0.
Torres, M. J., Romano, A., Celik, G., Demoly, P., Khan, D. A., Macy, E., Park, M., Blumenthal, K., Aberer, W., Castells, M., Barbaud, A., Mayorga, C., & Bonadonna, P. (2017). Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America. Clinical and translational allergy, 77. https://doi.org/10.1186/s13601-017-0144-0
Torres, M J, et al. "Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America." Clinical and translational allergy vol. 7 (2017): 7. doi: https://doi.org/10.1186/s13601-017-0144-0
Torres MJ, Romano A, Celik G, Demoly P, Khan DA, Macy E, Park M, Blumenthal K, Aberer W, Castells M, Barbaud A, Mayorga C, Bonadonna P. Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America. Clin Transl Allergy. 2017 Mar 13;7:7. doi: 10.1186/s13601-017-0144-0. eCollection 2017. PMID: 28293415; PMCID: PMC5347172.
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Clin Transl Allergy. 2017 Mar 13;7:7. doi: 10.1186/s13601-017-0144-0. eCollection 2017.

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

Clinical and translational allergy

M J Torres, A Romano, G Celik, P Demoly, D A Khan, E Macy, M Park, K Blumenthal, W Aberer, M Castells, A Barbaud, C Mayorga, P Bonadonna

Affiliations

  1. Allergy Unit, National Network ARADyAL, IBIMA-Regional University Hospital of Malaga-UMA (Pavilion C), Plaza del Hospital Civil, 29009 Malaga, Spain.
  2. BIONAND-Andalusian Centre for Nanomedicine and Biotechnology, Malaga, Spain.
  3. Allergy Unit, Presidio Columbus, Rome, Italy.
  4. IRCCS Oasi Maria S.S., Troina, Italy.
  5. Department of Chest Diseases, Division of Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey.
  6. Hôpital Arnaud de Villeneuve, University Hospital of Montpellier and Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, 75013 Paris, France.
  7. Department of Internal Medicine, Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, TX USA.
  8. Kaiser Permanente Health Care Program, San Diego, CA USA.
  9. Mayo Clinic College of Medicine, Division of Allergic Diseases, Mayo Clinic, Rochester, MN 55905 USA.
  10. Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA.
  11. Department of Dermatology, Medical University of Graz, Graz, Austria.
  12. Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MSA USA.
  13. Sorbonne Universities, UPMC Univ Paris 06, Dermatology and Allergology Department, Tenon Hospital (AP-HP), 4 rue de la chine, 75020 Paris, France.
  14. Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA (Pavilion C), Plaza del Hospital Civil, 29009 Malaga, Spain.
  15. Allergy Unit, Azienda Ospedaliera Universitaria Intergrata of Verona, Verona, Italy.

PMID: 28293415 PMCID: PMC5347172 DOI: 10.1186/s13601-017-0144-0

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: Allergy; Diagnosis; Drug; Drug provocation test; Europe; Hypersensitivity; IgE; In vitro test; Sensitization; Skin test; T-cells; United States

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