Allergy, Asthma & Respiratory Disease

The Korean Academy of Asthma, Allergy and Clinical Immunology (대한천식알레르기학회)
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Outcomes of drug provocation tests in Korean children with suspected drug hypersensitivity reaction

약물과민반응이 의심되는 한국 소아에서 약물유발검사 결과

  • Noh, Soo Ran (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yoon, Jisun (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Cho, Hyun-Ju (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Seongyoon (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Geun-Mi (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yu, Jinho (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Soo-Jong (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine)
  • 노수란 (울산대학교 의과대학 서울아산병원 소아청소년과 소아천식아토피 센터) ;
  • 윤지선 (울산대학교 의과대학 서울아산병원 소아청소년과 소아천식아토피 센터) ;
  • 조현주 (울산대학교 의과대학 서울아산병원 소아청소년과 소아천식아토피 센터) ;
  • 송승윤 (울산대학교 의과대학 서울아산병원 소아청소년과 소아천식아토피 센터) ;
  • 박근미 (울산대학교 의과대학 서울아산병원 소아청소년과 소아천식아토피 센터) ;
  • 유진호 (울산대학교 의과대학 서울아산병원 소아청소년과 소아천식아토피 센터) ;
  • 홍수종 (울산대학교 의과대학 서울아산병원 소아청소년과 소아천식아토피 센터)
  • Received : 2017.06.05
  • Accepted : 2017.08.23
  • Published : 2018.01.31
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Abstract

Purpose: Drug provocation tests (DPT) are the gold standard for confirming the diagnosis of drug hypersensitivity reactions (DHRs). However, there are little studies of DPT in children. The purpose of this study was to evaluate DPT results and safety as diagnostic methods of DHR in Korean children. Methods: We reviewed the medical records of 39 children under 18 years of age with a suspected DHR and performed DPT between January 2010 and May 2016 at Asan Medical Center. Results: Total 110 DPT were performed in 39 children (20 boys and 19 girls) with a history of DHR. Clinical presentation of DHR included skin rash (n = 7), pruritus (n = 3), urticaria (n = 18), angioedema (n = 19), dyspnea (n = 5), hoarseness (n = 1), hypothermia (n= 1), and anaphylaxis (n= 5). The median age at the time of DPT was 9 years. Positive DPT were observed in 21 of 39 children (53.8%) and 28 of 110 cases (25.5%). Drugs causing positive reactions were acetaminophen in 50% (9 of 18), nonsteroidal anti-inflammatory drugs in 29.2% (14 of 48), cephalosporin in 9.1% (1 of 11), trimethoprim/sulfamethoxazole in 50% (1 of 2), local anesthetics in 10% (1 of 10), and others (levodropropizine and idursulfase) in 15.4% (2 of 13). There was no statistical difference between children who had positive and negative results in sex, age, personal and parental history of allergic disease, eosinophil count, or total IgE level. Children with positive DPT did not develop anaphylaxis during the DPT procedure. Conclusion: Drug provocation test is safe, and it can be considered in children with suspected DHRs.

Keywords

References

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