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Drug allergy in children: what should we know?

  • Park, Ji Soo (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Suh, Dong In (Department of Pediatrics, Seoul National University College of Medicine)
  • 투고 : 2019.06.15
  • 심사 : 2019.11.12
  • 발행 : 2020.06.15

초록

The drug allergy "label" may have a lifetime of consequences for a child. Many children with alleged drug allergies are proven to be tolerant to the culprit medication when challenged. The field of drug hypersensitivity is a recently evolving field of research, but studies on its epidemiology and diagnostic tools are lacking in children. Clinical history is significant in the diagnosis and classification of drug hypersensitivity in children. Diagnostic tools have been evaluated in a limited number of children; therefore, the guidelines are mainly in line with those for adults. Here, we review the clinical characteristics, main drugs, risk factors, and diagnosis of drug hypersensitivity to aid in its accurate diagnosis in children.

키워드

참고문헌

  1. Impicciatore P, Choonara I, Clarkson A, Provasi D, Pandolfini C, Bonati M. Incidence of adverse drug reactions in paediatric in/out-patients: a systematic review and meta-analysis of prospective studies. Br J Clin Pharmacol 2001;52:77-83. https://doi.org/10.1046/j.0306-5251.2001.01407.x
  2. Vyles D, Chiu A, Simpson P, Nimmer M, Adams J, Brousseau DC. Parent-reported penicillin allergy symptoms in the Pediatric Emergency Department. Acad Pediatr 2017;17:251-5. https://doi.org/10.1016/j.acap.2016.11.004
  3. Smyth RM, Gargon E, Kirkham J, Cresswell L, Golder S, Smyth R, et al. Adverse drug reactions in children--a systematic review. PLoS One 2012;7:e24061. https://doi.org/10.1371/journal.pone.0024061
  4. Lee SI, Shin MH, Lee HB, Lee JS, Son BK, Koh YY, et al. Prevalences of symptoms of asthma and other allergic diseases in korean children: a nationwide questionnaire survey. J Korean Med Sci 2001;16:155-64. https://doi.org/10.3346/jkms.2001.16.2.155
  5. Rebelo Gomes E, Fonseca J, Araujo L, Demoly P. Drug allergy claims in children: from self-reporting to confirmed diagnosis. Clin Exp Allergy 2008;38:191-8. https://doi.org/10.1111/j.1365-2222.2007.02870.x
  6. Erkocoglu M, Kaya A, Civelek E, Ozcan C, Cakir B, Akan A, et al. Prevalence of confirmed immediate type drug hypersensitivity reactions among school children. Pediatr Allergy Immunol 2013;24:160-7. https://doi.org/10.1111/pai.12047
  7. Esposito S, Castellazzi L, Tagliabue C, Principi N. Allergy to antibiotics in children: an overestimated problem. Int J Antimicrob Agents 2016;48:361-6. https://doi.org/10.1016/j.ijantimicag.2016.08.001
  8. International drug monitoring: the role of national centres. Report of a WHO meeting. World Health Organ Tech Rep Ser 1972;498:1-25.
  9. Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet 2000;356:1255-9. https://doi.org/10.1016/S0140-6736(00)02799-9
  10. Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA, et al. International Consensus on drug allergy. Allergy 2014;69:420-37. https://doi.org/10.1111/all.12350
  11. Khan DA, Solensky R. Drug allergy. J Allergy Clin Immunol 2010;125(2 Suppl 2):S126-37. https://doi.org/10.1016/j.jaci.2009.10.028
  12. Pichler WJ. Delayed drug hypersensitivity reactions. Ann Intern Med 2003;139:683-93. https://doi.org/10.7326/0003-4819-139-8-200310210-00012
  13. Cohen AL, Budnitz DS, Weidenbach KN, Jernigan DB, Schroeder TJ, Shehab N, et al. National surveillance of emergency department visits for outpatient adverse drug events in children and adolescents. J Pediatr 2008;152:416-21. https://doi.org/10.1016/j.jpeds.2007.07.041
  14. Lange L, Koningsbruggen SV, Rietschel E. Questionnaire-based survey of lifetime-prevalence and character of allergic drug reactions in German children. Pediatr Allergy Immunol 2008;19:634-8. https://doi.org/10.1111/j.1399-3038.2007.00702.x
  15. Vezir E, Dibek Misirlioglu E, Civelek E, Capanoglu M, Guvenir H, Ginis T, et al. Direct oral provocation tests in non-immediate mild cutaneous reactions related to beta-lactam antibiotics. Pediatr Allergy Immunol 2016;27:50-4. https://doi.org/10.1111/pai.12493
  16. Gomes ER, Brockow K, Kuyucu S, Saretta F, Mori F, Blanca-Lopez N, et al. Drug hypersensitivity in children: report from the pediatric task force of the EAACI Drug Allergy Interest Group. Allergy 2016;71:149-61. https://doi.org/10.1111/all.12774
  17. Gamboa PM. The epidemiology of drug allergy-related consultations in Spanish Allergology services: Alergologica-2005. J Investig Allergol Clin Immunol 2009;19 Suppl 2:45-50.
  18. Rukasin CRF, Norton AE, Broyles AD. Pediatric drug hypersensitivity. Curr Allergy Asthma Rep 2019;19:11. https://doi.org/10.1007/s11882-019-0841-y
  19. Bergmann M, Caubet JC. Specific aspects of drug hypersensitivity in children. Curr Pharm Des 2016;22:6832-51. https://doi.org/10.2174/1381612822666160926105533
  20. Gomes ER, Demoly P. Epidemiology of hypersensitivity drug reactions. Curr Opin Allergy Clin Immunol 2005;5:309-16. https://doi.org/10.1097/01.all.0000173785.81024.33
  21. Kim B, Kim SZ, Lee J, Jung AH, Jung SH, Hahn HJ, et al. Clinical profiles of adverse drug reactions spontaneously reported at a single Korean hospital dedicated to children with complex chronic conditions. PLoS One 2017;12:e0172425. https://doi.org/10.1371/journal.pone.0172425
  22. Atanaskovic-Markovic M, Gomes E, Cernadas JR, du Toit G, Kidon M, Kuyucu S, et al. Diagnosis and management of drug-induced anaphylaxis in children: An EAACI position paper. Pediatr Allergy Immunol 2019;30:269-76. https://doi.org/10.1111/pai.13034
  23. Lee SY, Ahn K, Kim J, Jang GC, Min TK, Yang HJ, et al. A multicenter retrospective case study of anaphylaxis triggers by age in Korean children. Allergy Asthma Immunol Res 2016;8:535-40. https://doi.org/10.4168/aair.2016.8.6.535
  24. Motosue MS, Bellolio MF, Van Houten HK, Shah ND, Campbell RL. Increasing Emergency Department visits for anaphylaxis, 2005-2014. J Allergy Clin Immunol Pract 2017;5:171-5. https://doi.org/10.1016/j.jaip.2016.08.013
  25. Dibek Misirlioglu E, Guvenir H, Bahceci S, Haktanir Abul M, Can D, Usta Guc BE, et al. Severe cutaneous adverse drug reactions in pediatric patients: a multicenter study. J Allergy Clin Immunol Pract 2017;5:757-63. https://doi.org/10.1016/j.jaip.2017.02.013
  26. Duong TA, Valeyrie-Allanore L, Wolkenstein P, Chosidow O. Severe cutaneous adverse reactions to drugs. Lancet 2017;390:1996-2011. https://doi.org/10.1016/S0140-6736(16)30378-6
  27. Oh HL, Kang DY, Kang HR, Kim S, Koh YI, Kim SH, et al. Severe cutaneous adverse reactions in Korean pediatric patients: a study from the Korea SCAR Registry. Allergy Asthma Immunol Res 2019;11:241-53. https://doi.org/10.4168/aair.2019.11.2.241
  28. Park GM, Park JH, Jung JW, Han HW, Kim JY, Lee E, et al. Pediatric adverse drug reactions collected by an electronic reporting system in a single tertiary university hospital. Allergy Asthma Respir Dis 2016;4:354-9. https://doi.org/10.4168/aard.2016.4.5.354
  29. Kim DW, Choi YC, Lee YS, Nam YH, Jung JA. Analysis of pediatric adverse drug reactions reported to regional pharmacovigilance center of a single university hospital. Allergy Asthma Respir Dis 2018;6:263-9. https://doi.org/10.4168/aard.2018.6.5.263
  30. Romano A, Caubet JC. Antibiotic allergies in children and adults: from clinical symptoms to skin testing diagnosis. J Allergy Clin Immunol Pract 2014;2:3-12. https://doi.org/10.1016/j.jaip.2013.11.006
  31. Norton AE, Konvinse K, Phillips EJ, Broyles AD. Antibiotic allergy in pediatrics. Pediatrics 2018;141:e20172497. https://doi.org/10.1542/peds.2017-2497
  32. Trubiano JA, Stone CA, Grayson ML, Urbancic K, Slavin MA, Thursky KA, et al. The 3 Cs of antibiotic allergy-classification, cross-reactivity, and collaboration. J Allergy Clin Immunol Pract 2017;5:1532-42. https://doi.org/10.1016/j.jaip.2017.06.017
  33. Ibia EO, Schwartz RH, Wiedermann BL. Antibiotic rashes in children: a survey in a private practice setting. Arch Dermatol 2000;136:849-54.
  34. Na HR, Lee JM, Jung JW, Lee SY. Usefulness of drug provocation tests in children with a history of adverse drug reaction. Korean J Pediatr 2011;54:304-9. https://doi.org/10.3345/kjp.2011.54.7.304
  35. Noh SR, Yoon J, Cho HJ, Song S, Park GM, Yu J, et al. Outcomes of drug provocation tests in Korean children with suspected drug hypersensitivity reaction. Allergy Asthma Respir Dis 2018;6:26-33. https://doi.org/10.4168/aard.2018.6.1.26
  36. Zagursky RJ, Pichichero ME. Cross-reactivity in ${\beta}$-lactam allergy. J Allergy Clin Immunol Pract 2018;6:72-81. https://doi.org/10.1016/j.jaip.2017.08.027
  37. Tonson la Tour A, Michelet M, Eigenmann PA, Caubet JC. Natural history of benign nonimmediate allergy to beta-lactams in children: a prospective study in retreated patients after a positive and a negative provocation test. J Allergy Clin Immunol Pract 2018;6:1321-6. https://doi.org/10.1016/j.jaip.2017.10.008
  38. Neubert A, Verhamme K, Murray ML, Picelli G, Hsia Y, Sen FE, et al. The prescribing of analgesics and non-steroidal anti-inflammatory drugs in paediatric primary care in the UK, Italy and the Netherlands. Pharmacol Res 2010;62:243-8. https://doi.org/10.1016/j.phrs.2010.04.006
  39. Lesko SM, Mitchell AA. The safety of acetaminophen and ibuprofen among children younger than two years old. Pediatrics 1999;104:e39. https://doi.org/10.1542/peds.104.4.e39
  40. Eustace N, O'Hare B. Use of nonsteroidal anti-inflammatory drugs in infants. A survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland. Paediatr Anaesth 2007;17:464-9. https://doi.org/10.1111/j.1460-9592.2007.02135.x
  41. Settipane RA, Constantine HP, Settipane GA. Aspirin intolerance and recurrent urticaria in normal adults and children. Epidemiology and review. Allergy 1980;35:149-54. https://doi.org/10.1111/j.1398-9995.1980.tb01730.x
  42. Dona I, Blanca-Lopez N, Torres MJ, Garcia-Campos J, Garcia-Nunez I, Gomez F, et al. Drug hypersensitivity reactions: response patterns, drug involved, and temporal variations in a large series of patients. J Investig Allergol Clin Immunol 2012;22:363-71.
  43. Guvenir H, Dibek Misirlioglu E, Capanoglu M, Buyuktiryaki B, Onay ZR, Ginis T, et al. The frequency of nonsteroidal anti-inflammatory drug hypersensitivity in children with asthma. Int Arch Allergy Immunol 2018;176:26-32. https://doi.org/10.1159/000487305
  44. Liew WK, Chiang WC, Goh AE, Lim HH, Chay OM, Chang S, et al. Paediatric anaphylaxis in a Singaporean children cohort: changing food allergy triggers over time. Asia Pac Allergy 2013;3:29-34. https://doi.org/10.5415/apallergy.2013.3.1.29
  45. Gabrielli S, Clarke AE, Eisman H, Morris J, Joseph L, La Vieille S, et al. Disparities in rate, triggers, and management in pediatric and adult cases of suspected drug-induced anaphylaxis in Canada. Immun Inflamm Dis 2018;6:3-12. https://doi.org/10.1002/iid3.201
  46. Jares EJ, Baena-Cagnani CE, Sanchez-Borges M, Ensina LF, Arias-Cruz A, Gomez M, et al. Drug-induced anaphylaxis in latin american countries. J Allergy Clin Immunol Pract 2015;3:780-8. https://doi.org/10.1016/j.jaip.2015.05.012
  47. Choi J, Lee JY, Kim KH, Choi J, Ahn K, Kim J. Evaluation of drug provocation tests in Korean children: a single center experience. Asian Pac J Allergy Immunol 2016;34:130-6.
  48. Stevenson DD, Sanchez-Borges M, Szczeklik A. Classification of allergic and pseudoallergic reactions to drugs that inhibit cyclooxygenase enzymes. Ann Allergy Asthma Immunol 2001;87:177-80. https://doi.org/10.1016/S1081-1206(10)62221-1
  49. Kowalski ML, Asero R, Bavbek S, Blanca M, Blanca-Lopez N, Bochenek G, et al. Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs. Allergy 2013;68:1219-32. https://doi.org/10.1111/all.12260
  50. Kidon M, Blanca-Lopez N, Gomes E, Terreehorst I, Tanno L, Ponvert C, et al. EAACI/ENDA position paper: diagnosis and management of hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAIDs) in children and adolescents. Pediatr Allergy Immunol 2018;29:469-80. https://doi.org/10.1111/pai.12915
  51. Sanchez-Borges M, Capriles-Behrens E, Caballero-Fonseca F. Hypersensitivity to non-steroidal anti-inflammatory drugs in childhood. Pediatr Allergy Immunol 2004;15:376-80. https://doi.org/10.1111/j.1399-3038.2004.00159.x
  52. Corzo JL, Zambonino MA, Munoz C, Mayorga C, Requena G, Urda A, et al. Tolerance to COX-2 inhibitors in children with hypersensitivity to nonsteroidal anti-inflammatory drugs. Br J Dermatol 2014;170:725-9. https://doi.org/10.1111/bjd.12674
  53. Kelso JM, Greenhawt MJ, Li JT, Nicklas RA, Bernstein DI, Blessing-Moore J, et al. Adverse reactions to vaccines practice parameter 2012 update. J Allergy Clin Immunol 2012;130:25-43. https://doi.org/10.1016/j.jaci.2012.04.003
  54. McNeil MM, DeStefano F. Vaccine-associated hypersensitivity. J Allergy Clin Immunol 2018;141:463-72. https://doi.org/10.1016/j.jaci.2017.12.971
  55. Caubet JC, Ponvert C. Vaccine allergy. Immunol Allergy Clin North Am 2014;34:597-613. https://doi.org/10.1016/j.iac.2014.04.004
  56. McNeil MM, Weintraub ES, Duffy J, Sukumaran L, Jacobsen SJ, Klein NP, et al. Risk of anaphylaxis after vaccination in children and adults. J Allergy Clin Immunol 2016;137:868-78. https://doi.org/10.1016/j.jaci.2015.07.048
  57. Grohskopf LA, Sokolow LZ, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices- United States, 2018-19 Influenza Season. MMWR Recomm Rep 2018;67:1-20.
  58. Joint Task Force on Practice Parameters; American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, et al. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol 2010;105:259-73. https://doi.org/10.1016/j.anai.2010.08.002
  59. Romano A, Gaeta F, Valluzzi RL, Alonzi C, Viola M, Bousquet PJ. Diagnosing hypersensitivity reactions to cephalosporins in children. Pediatrics 2008;122:521-7. https://doi.org/10.1542/peds.2007-3178
  60. Caubet JC, Kaiser L, Lemaitre B, Fellay B, Gervaix A, Eigenmann PA. The role of penicillin in benign skin rashes in childhood: a prospective study based on drug rechallenge. J Allergy Clin Immunol 2011;127:218-22. https://doi.org/10.1016/j.jaci.2010.08.025
  61. Ponvert C, Perrin Y, Bados-Albiero A, Le Bourgeois M, Karila C, Delacourt C, et al. Allergy to betalactam antibiotics in children: results of a 20-year study based on clinical history, skin and challenge tests. Pediatr Allergy Immunol 2011;22:411-8. https://doi.org/10.1111/j.1399-3038.2011.01169.x
  62. Atanaskovic-Markovic M, Gaeta F, Gavrovic-Jankulovic M, Cirkovic Velickovic T, Valluzzi RL, Romano A. Diagnosing multiple drug hypersensitivity in children. Pediatr Allergy Immunol 2012;23:785-91. https://doi.org/10.1111/pai.12020
  63. Brockow K, Garvey LH, Aberer W, Atanaskovic-Markovic M, Barbaud A, Bilo MB, et al. Skin test concentrations for systemically administered drugs -- an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy 2013;68:702-12. https://doi.org/10.1111/all.12142
  64. Lezmi G, Alrowaishdi F, Bados-Albiero A, Scheinmann P, de Blic J, Ponvert C. Non-immediate-reading skin tests and prolonged challenges in non-immediate hypersensitivity to beta-lactams in children. Pediatr Allergy Immunol 2018;29:84-9. https://doi.org/10.1111/pai.12826
  65. Saretta F, Mori F, Cardinale F, Liotti L, Franceschini F, Crisafulli G, et al. Pediatric drug hypersensitivity: which diagnostic tests? Acta Biomed 2019;90(3-S):94-107.
  66. Confino-Cohen R, Rosman Y, Meir-Shafrir K, Stauber T, Lachover-Roth I, Hershko A, et al. Oral challenge without skin testing safely excludes clinically significant delayed-onset penicillin hypersensitivity. J Allergy Clin Immunol Pract 2017;5:669-75. https://doi.org/10.1016/j.jaip.2017.02.023
  67. Mayorga C, Celik G, Rouzaire P, Whitaker P, Bonadonna P, Rodrigues-Cernadas J, et al. In vitro tests for drug hypersensitivity reactions: an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy 2016;71:1103-34. https://doi.org/10.1111/all.12886
  68. Sanz ML, Gamboa PM, Mayorga C. Basophil activation tests in the evaluation of immediate drug hypersensitivity. Curr Opin Allergy Clin Immunol 2009;9:298-304. https://doi.org/10.1097/ACI.0b013e32832d5311
  69. De Week AL, Sanz ML, Gamboa PM, Aberer W, Sturm G, Bilo MB, et al. Diagnosis of immediate-type beta-lactam allergy in vitro by flowcytometric basophil activation test and sulfidoleukotriene production: a multicenter study. J Investig Allergol Clin Immunol 2009;19:91-109.
  70. Pichler WJ, Tilch J. The lymphocyte transformation test in the diagnosis of drug hypersensitivity. Allergy 2004;59:809-20. https://doi.org/10.1111/j.1398-9995.2004.00547.x
  71. Polak ME, Belgi G, McGuire C, Pickard C, Healy E, Friedmann PS, et al. In vitro diagnostic assays are effective during the acute phase of delayedtype drug hypersensitivity reactions. Br J Dermatol 2013;168:539-49. https://doi.org/10.1111/bjd.12109
  72. Porebski G, Pecaric-Petkovic T, Groux-Keller M, Bosak M, Kawabata TT, Pichler WJ. In vitro drug causality assessment in Stevens-Johnson syndrome - alternatives for lymphocyte transformation test. Clin Exp Allergy 2013;43:1027-37. https://doi.org/10.1111/cea.12145
  73. Aberer W, Bircher A, Romano A, Blanca M, Campi P, Fernandez J, et al. Drug provocation testing in the diagnosis of drug hypersensitivity reactions: general considerations. Allergy 2003;58:854-63. https://doi.org/10.1034/j.1398-9995.2003.00279.x
  74. Mill C, Primeau MN, Medoff E, Lejtenyi C, O'Keefe A, Netchiporouk E, et al. Assessing the diagnostic properties of a graded oral provocation challenge for the diagnosis of immediate and nonimmediate reactions to amoxicillin in children. JAMA Pediatr 2016;170:e160033. https://doi.org/10.1001/jamapediatrics.2016.0033
  75. Labrosse R, Paradis L, Lacombe-Barrios J, Samaan K, Graham F, Paradis J, et al. Efficacy and safety of 5-day challenge for the evaluation of nonsevere amoxicillin allergy in children. J Allergy Clin Immunol Pract 2018;6:1673-80. https://doi.org/10.1016/j.jaip.2018.01.030
  76. Zambonino MA, Torres MJ, Munoz C, Requena G, Mayorga C, Posadas T, et al. Drug provocation tests in the diagnosis of hypersensitivity reactions to non-steroidal anti-inflammatory drugs in children. Pediatr Allergy Immunol 2013;24:151-9. https://doi.org/10.1111/pai.12039
  77. Rieder M. Adverse drug reactions in children: pediatric pharmacy and drug safety. J Pediatr Pharmacol Ther 2019;24:4-9.
  78. Menniti-Ippolito G, Raschetti R, Da Cas R, Giaquinto C, Cantarutti L. Active monitoring of adverse drug reactions in children. Italian Paediatric Pharmacosurveillance Multicenter Group. Lancet 2000;355:1613-4. https://doi.org/10.1016/S0140-6736(00)02219-4
  79. Gallagher RM, Mason JR, Bird KA, Kirkham JJ, Peak M, Williamson PR, et al. Adverse drug reactions causing admission to a paediatric hospital. PLoS One 2012;7:e50127. https://doi.org/10.1371/journal.pone.0050127
  80. Rashed AN, Wong IC, Cranswick N, Tomlin S, Rascher W, Neubert A. Risk factors associated with adverse drug reactions in hospitalised children: international multicentre study. Eur J Clin Pharmacol 2012;68:801-10. https://doi.org/10.1007/s00228-011-1183-4
  81. Chovel-Sella A, Ben Tov A, Lahav E, Mor O, Rudich H, Paret G, et al. Incidence of rash after amoxicillin treatment in children with infectious mononucleosis. Pediatrics 2013;131:e1424-e1427. https://doi.org/10.1542/peds.2012-1575
  82. Mardivirin L, Valeyrie-Allanore L, Branlant-Redon E, Beneton N, Jidar K, Barbaud A, et al. Amoxicillin-induced flare in patients with DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms): report of seven cases and demonstration of a direct effect of amoxicillin on Human Herpesvirus 6 replication in vitro. Eur J Dermatol 2010;20:68-73. https://doi.org/10.1684/ejd.2010.0821
  83. Frattarelli DA, Galinkin JL, Green TP, Johnson TD, Neville KA, Paul IM, et al. Off-label use of drugs in children. Pediatrics 2014;133:563-7. https://doi.org/10.1542/peds.2013-4060

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