Results of drug hypersensitivity evaluations in a large group of children and adults

M. Rubio, P. J. Bousquet, E. Gomes, A. Romano, P. Demoly

Research output: Contribution to journalArticle

Abstract

Background: Proven IgE or T-cell mediated drug hypersensitivity reactions (DHRs) seem less common in children compared with adults. However, this has never been proved by data. Objective: To determine and compare proven DHR prevalence in children and adults. Methods: Using the DAHD (Drug Allergy and Hypersensitivity Database) cohort, children with proven DHRs were compared with adults. The international EAACI-ENDA recommendations were followed. Patients were divided into four groups: index reaction and test during childhood (C/C), index reaction at childhood and test at adulthood (C/A), index reactions at childhood and adulthood and test at adulthood (CA/A), index reaction and test at adulthood (A/A). Results: A total of 3275 patients (67.9% female), comprising a total of 4370 patient-episodes, were evaluated (74.5% belonged to the A/A group). Prevalence of positive tests was 15.2% (95%CI, 14.1-16.2) for all tested classes, 10.6% (8.3-13.0) for C/C, 10.6% (7.5-13.6) for C/A, 22.1% (12.8-31.3) for CA/A and 16.5% (15.2-17.8) for A/A. The prevalence was lower in group C/C compared with groups A/A (P <0.0001) and CA/A (P = 0.003). It was also lower in group C/A compared with the two latter groups (respectively P = 0.003 and P = 0.005). Significant differences were found for maculopapular exanthemas only, and not for urticaria/angiœdema and anaphylaxis. The difference was mainly observed with β-lactams and not for NSAIDs. Conclusion and Clinical Relevance: Suspicions of DHRs are less likely to be confirmed in children.

Original languageEnglish
Pages (from-to)123-130
Number of pages8
JournalClinical and Experimental Allergy
Volume42
Issue number1
DOIs
Publication statusPublished - Jan 2012

Keywords

  • DAHD database
  • Diagnosis
  • Drug allergy
  • Drug hypersensitivity
  • Risk prediction

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

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