Antituberculosis drug-induced non-blistering systemic severe reactions: A 10-year (2012-2022) literature review.

IF 2.3 4区 医学 Q3 ALLERGY
Angela Rizzi, Eleonora Nucera, Sara Urbani, David Longhino, Franziska Michaela Lohmeyer, Giovanni Gambassi, Nateetip Krishnamra, Luca Gammeri, Sebastiano Gangemi, Riccardo Inchingolo
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引用次数: 0

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) and drug-induced liver injury (DILI) can hamper therapeutic strategy, contribute to multiple drug resistance and serious public health burden. Diagnosis (including allergy assessment) and management of these two severe hypersensitivity reactions in clinical practice are somewhat difficult and published scientific evidence is rather weak and limited. The first step is always represented by stopping all anti-tuberculosis (TB) drugs, treating reaction with systemic corticosteroids, and identifying the offending drug, even if it is often complicated by the patient's simultaneous intake of antibiotics. Patch tests and in vitro tests, such as lymphocyte transformation test, could bridge this diagnostic gap, but the available data are scarce and their sensitivity low. The re-challenge test is often necessary but places patients at risk for serious adverse reactions. The desensitization protocols are quite varied and not universally accepted. In this narrative review, we provide an update to the literature data on the management of DRESS and DILI with particular attention to the allergological work-up in the last decade.

抗结核药物诱导的非起泡全身严重反应:10年(2012-2022)文献综述。
嗜酸性粒细胞增多症和全身症状(DRESS)以及药物性肝损伤(DILI)的药物反应会阻碍治疗策略,导致多重耐药性和严重的公共卫生负担。在临床实践中,这两种严重超敏反应的诊断(包括过敏评估)和管理有些困难,并且已发表的科学证据相当薄弱和有限。第一步总是停止所有抗结核病药物,用全身皮质类固醇治疗反应,并确定违规药物,即使患者同时摄入抗生素往往会使其变得复杂。斑贴试验和淋巴细胞转化试验等体外试验可以弥补这一诊断差距,但现有数据稀少,敏感性低。再激发试验通常是必要的,但会使患者面临严重不良反应的风险。脱敏方案多种多样,并非普遍接受。在这篇叙述性综述中,我们提供了关于DRESS和DILI管理的文献数据的更新,特别关注过去十年的过敏性检查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
12.80
自引率
0.00%
发文量
74
审稿时长
>12 weeks
期刊介绍: The Asian Pacific Journal of Allergy and Immunology (APJAI) is an online open access journal with the recent impact factor (2018) 1.747 APJAI published 4 times per annum (March, June, September, December). Four issues constitute one volume. APJAI publishes original research articles of basic science, clinical science and reviews on various aspects of allergy and immunology. This journal is an official journal of and published by the Allergy, Asthma and Immunology Association, Thailand. The scopes include mechanism, pathogenesis, host-pathogen interaction, host-environment interaction, allergic diseases, immune-mediated diseases, epidemiology, diagnosis, treatment and prevention, immunotherapy, and vaccine. All papers are published in English and are refereed to international standards.
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