Management of drug allergy-clinical update
The new classification of drug hypersensitivity reactions (DHRs) is based on phenotypes, endotypes, and biomarkers. Immediate and delayed reactions are the clinical phenotypic presentation while endotypes are based on cellular, biological mediators, and biomarkers. Complement activation, cyclooxygen...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Indian Journal of Allergy Asthma and Immunology |
| Subjects: | |
| Online Access: | http://www.ijaai.in/article.asp?issn=0972-6691;year=2022;volume=36;issue=1;spage=4;epage=17;aulast=Kathuria |
| _version_ | 1797775196793339904 |
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| author | P C Kathuria Manisha Rai |
| author_facet | P C Kathuria Manisha Rai |
| author_sort | P C Kathuria |
| collection | DOAJ |
| description | The new classification of drug hypersensitivity reactions (DHRs) is based on phenotypes, endotypes, and biomarkers. Immediate and delayed reactions are the clinical phenotypic presentation while endotypes are based on cellular, biological mediators, and biomarkers. Complement activation, cyclooxygenase-1 inhibition, Mas-Related G Protein-Coupled Receptor-X2 (MRGPRX2), Cytokine release syndrome (CRS) is also included in DHRs due to mast cell activation e.g., radio contrast media, nonsteroidal anti-inflammatory drugs, monoclonal antibodies, oxaliplatin and taxanes, etc. Genetic predisposition of specific human leukocyte antigen alleles has been associated with the development of T cell-mediated symptoms of severe cutaneous adverse reactions (SCAR), which includes acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necroplasia, due to antibiotics, retrovirus and anti-convulsant drugs, etc., drug desensitization (Ds), is a personalized treatment approach for immunoglobulin E (IgE), and Non-IgE mediated DHRs, for example, antibiotics, biologicals, chemotherapy, etc. This review will update on the mechanism of DHRs, the clinical approach of alternative drugs, and Ds in a high-risk patient. |
| first_indexed | 2024-03-12T22:32:15Z |
| format | Article |
| id | doaj.art-11a912eb3f304e7f8c4ee00bd011f8a9 |
| institution | Directory Open Access Journal |
| issn | 0972-6691 |
| language | English |
| last_indexed | 2024-03-12T22:32:15Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Allergy Asthma and Immunology |
| spelling | doaj.art-11a912eb3f304e7f8c4ee00bd011f8a92023-07-21T14:45:39ZengWolters Kluwer Medknow PublicationsIndian Journal of Allergy Asthma and Immunology0972-66912022-01-0136141710.4103/ijaai.ijaai_34_22Management of drug allergy-clinical updateP C KathuriaManisha RaiThe new classification of drug hypersensitivity reactions (DHRs) is based on phenotypes, endotypes, and biomarkers. Immediate and delayed reactions are the clinical phenotypic presentation while endotypes are based on cellular, biological mediators, and biomarkers. Complement activation, cyclooxygenase-1 inhibition, Mas-Related G Protein-Coupled Receptor-X2 (MRGPRX2), Cytokine release syndrome (CRS) is also included in DHRs due to mast cell activation e.g., radio contrast media, nonsteroidal anti-inflammatory drugs, monoclonal antibodies, oxaliplatin and taxanes, etc. Genetic predisposition of specific human leukocyte antigen alleles has been associated with the development of T cell-mediated symptoms of severe cutaneous adverse reactions (SCAR), which includes acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necroplasia, due to antibiotics, retrovirus and anti-convulsant drugs, etc., drug desensitization (Ds), is a personalized treatment approach for immunoglobulin E (IgE), and Non-IgE mediated DHRs, for example, antibiotics, biologicals, chemotherapy, etc. This review will update on the mechanism of DHRs, the clinical approach of alternative drugs, and Ds in a high-risk patient.http://www.ijaai.in/article.asp?issn=0972-6691;year=2022;volume=36;issue=1;spage=4;epage=17;aulast=Kathuriaacute generalized exanthematous pustulosisadverse drug reactiondesensitization modelsdesensitizationdrug allergydrug hypersensitivity reactiondrug rash with eosinophilia and systemic symptomshigh-affinity immunoglobulin e fcε receptor iimmunoglobulin escarstevens-johnson syndrometoxic epidermal necroplasia |
| spellingShingle | P C Kathuria Manisha Rai Management of drug allergy-clinical update Indian Journal of Allergy Asthma and Immunology acute generalized exanthematous pustulosis adverse drug reaction desensitization models desensitization drug allergy drug hypersensitivity reaction drug rash with eosinophilia and systemic symptoms high-affinity immunoglobulin e fcε receptor i immunoglobulin e scar stevens-johnson syndrome toxic epidermal necroplasia |
| title | Management of drug allergy-clinical update |
| title_full | Management of drug allergy-clinical update |
| title_fullStr | Management of drug allergy-clinical update |
| title_full_unstemmed | Management of drug allergy-clinical update |
| title_short | Management of drug allergy-clinical update |
| title_sort | management of drug allergy clinical update |
| topic | acute generalized exanthematous pustulosis adverse drug reaction desensitization models desensitization drug allergy drug hypersensitivity reaction drug rash with eosinophilia and systemic symptoms high-affinity immunoglobulin e fcε receptor i immunoglobulin e scar stevens-johnson syndrome toxic epidermal necroplasia |
| url | http://www.ijaai.in/article.asp?issn=0972-6691;year=2022;volume=36;issue=1;spage=4;epage=17;aulast=Kathuria |
| work_keys_str_mv | AT pckathuria managementofdrugallergyclinicalupdate AT manisharai managementofdrugallergyclinicalupdate |