Clinical presentation and time course in hypersensitivity reactions to β-lactams
Clinical presentation and time course in hypersensitivity reactions to β-lactams
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DOI：
10.1111/j.1398-9995.2007.01463.x
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发表时间：
2007-08-01
期刊：
影响因子：
12.4
通讯作者：
Demoly, P.
中科院分区：
文献类型：
--
作者：
Bousquet, P. J.;Kvedariene, V.;Demoly, P.
背景：β-内酰胺超敏反应分为速发型和非速发型。诊断通常是基于皮肤试验和激发challenges.Objective：在已证实的β-内酰胺类超敏反应的反应的时间过程进行了研究，然后与症状，以确定临床表现和时间course.Methods之间的关系：所有的病人谁咨询1996年和2004年之间的疑似β-内酰胺类超敏反应进行了研究。结果：2010例经欧洲药物过敏网络诊断为过敏反应的患者中，36.7%的患者以荨麻疹为单一症状，19.1%的患者有过敏反应而无休克，17.6%的患者有过敏性休克，19.1%的患者有斑丘疹样皮疹。过敏性休克和过敏反应多发生在给药后1 h内。主要发生在24 h后。荨麻疹作为单一症状可随时发生。一个坚定的诊断是确定使用即时阅读皮肤点刺（10.0%）和皮内试验（38.1%），迟读皮试（19.1%）或激发试验结论和临床意义：根据反应的时间进程，将其分为三个临床组：过敏性反应和过敏性休克（即时反应）;斑丘疹性皮疹（晚期反应）以及荨麻疹（即时和晚期反应）。
Background: beta-lactam hypersensitivity reactions are classified as immediate or nonimmediate. Diagnosis is usually based upon skin tests and provocation challenges.Objective: The time course of the reactions in proven beta-lactam hypersensitivities was studied and then correlated with the symptoms to determine the relationship between the clinical presentations and the time course.Methods: All of the patients who consulted between 1996 and 2004 for a suspected beta-lactam hypersensitivity reaction were studied. Two hundred and ten patients with a proven hypersensitivity reaction diagnosed according to the European Network on Drug Allergy were included in the present study.Results: Of the patients, 36.7% had urticaria as a single symptom, 19.1% anaphylaxis without shock, 17.6% anaphylactic shock and 19.1% maculopapular exanthema. Anaphylactic shock and anaphylaxis mostly occurred within 1 h after drug administration. Exanthema mainly occurred after 24 h. Urticaria as a single symptom occurred at any time. A firm diagnosis was determined using immediate-reading skin prick (10.0%) and intradermal tests (38.1%), late-reading skin tests (19.1%) or provocation tests (32.9%).Conclusion and clinical implications: Depending on the time course of the reaction, three clinical groups were identified: anaphylaxis and anaphylactic shock (immediate reaction); maculopapular exanthema (late reaction) as well as urticaria (immediate and late reaction).