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首页> 外文期刊>Allergy >Severe drug-induced anaphylaxis: Analysis of 333 cases recorded by the Allergy Vigilance Network from 2002 to 2010
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Severe drug-induced anaphylaxis: Analysis of 333 cases recorded by the Allergy Vigilance Network from 2002 to 2010

机译：严重的药物过敏反应：过敏警戒网2002年至2010年记录的333例病例的分析

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Background A few series of well-documented cases of severe drug-induced anaphylaxis (SDA) are available. Methods Cases collected by the Allergy Vigilance Network from 2002 to 2010 were analyzed for clinical signs, causative drugs, and efficacy of a stepwise approach to diagnosis, using skin tests, laboratory tests, and oral challenges. Results Three hundred and thirty-three cases concerned 300 adults (90.1%) and 33 children (9.9%): 206 females (61.9%) and 127 males (38.1%). Mean age was 42.7 ± 18 years. Anaphylactic shock (76.6%), severe systemic reactions (10.5%), acute laryngeal edema (9%), severe bronchospasm (2.1%), and six fatal cases (1.8%) were recorded. There were 270 cases (81.1%) of ambulatory anaphylaxis. Sixty-three cases (18.9%) occurred during anesthesia. Hospitalization was required in 94.8% of cases. 23.7% of patients were admitted to an intensive care unit. Epinephrine was used in 57.9% of cases. Eighty-four drugs were incriminated: antibiotics (49.6%), muscle relaxants, latex and anesthetics (15%), nonsteroidal anti-inflammatory drugs (10.2%), acetaminophen (3.9%), iodinated or magnetic resonance imaging contrast media (4.2%), immunotherapy and vaccines (3.9%), and other drugs (13%). Among antibiotics, amoxicillin (97 cases), other penicillins (four cases), cephalosporins (41 cases), quinolones (15 cases), and pristinamycin (seven cases) were the most common. The diagnosis of drug hypersensitivity was obtained by skin tests in 72.9%, laboratory tests only in 2.4% of cases, and oral challenges (OCs) only in 3.9% of cases. Conclusions Three hundred and thirty-three case reports provided data on drugs involved in severe anaphylaxis. The efficacy of skin tests and poor use of laboratory tests are underlined. Further progress may depend on OCs.
机译：背景技术已有一系列证据充分的严重药物诱发过敏反应（SDA）病例。方法使用皮肤测试，实验室测试和口腔检查对2002年至2010年过敏性警惕网络收集的病例进行临床体征，病原性药物和逐步诊断方法的疗效分析。结果333例患者中，有300名成人（90.1％）和33名儿童（9.9％）：女性206名（61.9％）和男性127名（38.1％）。平均年龄为42.7±18岁。记录到过敏性休克（76.6％），严重全身反应（10.5％），急性喉头水肿（9％），严重支气管痉挛（2.1％）和6例致命病例（1.8％）。动态过敏反应270例（81.1％）。麻醉过程中发生了63例（18.9％）。 94.8％的病例需要住院治疗。 23.7％的患者被送往重症监护室。 57.9％的患者使用肾上腺素。涉及八十四种药物：抗生素（49.6％），肌肉松弛剂，乳胶和麻醉药（15％），非甾体抗炎药（10.2％），对乙酰氨基酚（3.9％），碘化或磁共振成像造影剂（4.2％） ），免疫疗法和疫苗（3.9％）以及其他药物（13％）。在抗生素中，最常见的是阿莫西林（97例），其他青霉素（4例），头孢菌素（41例），喹诺酮（15例）和新霉素（7例）。通过皮肤测试获得的药物过敏反应诊断率为72.9％，仅通过实验室测试获得的诊断率为2.4％，仅通过口试（OCs）的诊断率为3.9％。结论333例病例报告提供了与严重过敏反应有关的药物数据。强调了皮肤测试的有效性和实验室测试的不良使用。进一步的进展可能取决于OC。

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