RT Journal Article
T1 Epidemiology, Mechanisms, and Diagnosis of Drug-Induced Anaphylaxis.
A1 Montañez, Maria Isabel
A1 Mayorga, Cristobalina
A1 Bogas, Gador
A1 Barrionuevo, Esther
A1 Fernandez-Santamaria, Ruben
A1 Martin-Serrano, Angela
A1 Laguna, Jose Julio
A1 Torres, Maria José
A1 Fernandez, Tahia Diana
A1 Doña, Inmaculada
K1 IgE
K1 IgG
K1 MAS-related G protein-coupled receptor
K1 anaphylaxis
K1 drugs
K1 in vitro tests
K1 in vivo diagnosis
AB Anaphylaxis is an acute, life-threatening, multisystem syndrome resulting from the sudden release of mediators by mast cells and basophils. Although anaphylaxis is often under-communicated and thus underestimated, its incidence appears to have risen over recent decades. Drugs are among the most common triggers in adults, being analgesics and antibiotics the most common causal agents. Anaphylaxis can be caused by immunologic or non-immunologic mechanisms. Immunologic anaphylaxis can be mediated by IgE-dependent or -independent pathways. The former involves activation of Th2 cells and the cross-linking of two or more specific IgE (sIgE) antibodies on the surface of mast cells or basophils. The IgE-independent mechanism can be mediated by IgG, involving the release of platelet-activating factor, and/or complement activation. Non-immunological anaphylaxis can occur through the direct stimulation of mast cell degranulation by some drugs, inducing histamine release and leading to anaphylactic symptoms. Work-up of a suspected drug-induced anaphylaxis should include clinical history; however, this can be unreliable, and skin tests should also be used if available and validated. Drug provocation testing is not recommended due to the risk of inducing a harmful reaction. In vitro testing can help to confirm anaphylaxis by analyzing the release of mediators such as tryptase or histamine by mast cells. When immunologic mechanisms are suspected, serum-sIgE quantification or the use of the basophil activation test can help confirm the culprit drug. In this review, we will discuss multiple aspects of drug-induced anaphylaxis, including epidemiology, mechanisms, and diagnosis.
SN 1664-3224
YR 2017
FD 2017-05-29
LK https://hdl.handle.net/10668/26012
UL https://hdl.handle.net/10668/26012
LA en
DS RISalud
RD Apr 6, 2025