17 results on '"Drug Hypersensitivity diagnosis"'
Search Results
2. Suspected perioperative anaphylaxis: are we making the correct diagnosis?
- Author
-
Ebo DG, van der Poorten MM, and Hopkins PM
- Subjects
- Humans, Prospective Studies, Sensitivity and Specificity, Skin Tests, Anaphylaxis diagnosis, Anaphylaxis epidemiology, Hypersensitivity, Immediate diagnosis, Drug Hypersensitivity diagnosis
- Abstract
We provide a commentary on aspects of a prospective study of the epidemiology of perioperative anaphylaxis in Japan (Japanese Epidemiologic Study for Perioperative Anaphylaxis [JESPA]). Accurate diagnosis of perioperative anaphylaxis is important for research but essential for clinical safety. We evaluate the diagnostic approach used in the JESPA study and caution against over-reliance on diagnostic tests that lack sensitivity and specificity when clinical data suggest an immediate perioperative hypersensitivity reaction is likely., (Copyright © 2023. Published by Elsevier Ltd.)
- Published
- 2023
- Full Text
- View/download PDF
3. Immediate hypersensitivity reactions to antineoplastic agents - A practical guide for the oncologist.
- Author
-
Seghers S, Teuwen LA, Beyens M, De Blick D, Sabato V, Ebo DG, and Prenen H
- Subjects
- Humans, Antibodies, Monoclonal therapeutic use, Drug Hypersensitivity diagnosis, Drug Hypersensitivity epidemiology, Drug Hypersensitivity etiology, Antineoplastic Agents therapeutic use, Hypersensitivity, Immediate chemically induced, Hypersensitivity, Immediate complications, Hypersensitivity, Immediate drug therapy, Neoplasms complications, Oncologists
- Abstract
Immediate hypersensitivity reactions (IHRs) to antineoplastic agents occur frequently, and every oncologist will encounter these reactions in their clinical practice at some point. The clinical signature of IHRs can range from mild to life-threatening, and their occurrence can substantially impede the treatment course of patients with cancer. Yet, clear guidelines regarding the diagnosis and management are scarce, especially from an oncologic point of view. Therefore, herein, we review the definition, pathophysiology, epidemiology, diagnosis and management of IHRs to chemotherapeutic agents and monoclonal antibodies. First, we focus on defining the specific entities that comprise IHRs and discuss their underlying mechanisms. Then, we summarize the epidemiology for the antineoplastic agents that represent the most common causes of IHRs, i.e., platinum compounds, taxanes and monoclonal antibodies (mAbs). Next, we describe the possible clinical pictures and the comprehensive diagnostic work-up that should be executed to identify the culprit and safe alternatives for the future. Finally, we finish with reviewing the treatment options in both the acute phase and after recovery, with the aim to improve the oncologic care of patients with cancer., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
4. Agreement of a clinical scoring system with allergic anaphylaxis in suspected perioperative hypersensitivity reactions: prospective validation of a new tool.
- Author
-
Sadleir PHM, Clarke RC, Goddard CE, Mickle P, and Platt PR
- Subjects
- Humans, Tryptases, Skin Tests methods, Immunoglobulin E, Anaphylaxis diagnosis, Anaphylaxis etiology, Hypersensitivity, Immediate, Drug Hypersensitivity diagnosis
- Abstract
Background: A clinical scoring system to estimate the likelihood that a reaction represents a perioperative immediate hypersensitivity reaction has been devised using a Delphi consensus process. Agreement of this clinical scoring system with the outcome of allergological assessment would allow the use of this tool in post-resuscitation and subsequent management of suspected perioperative immediate hypersensitivity reaction and potentially as a new standard reference for clinical investigations., Methods: We prospectively scored 301 cases of suspected perioperative immediate hypersensitivity reaction according to the Hypersensitivity Clinical Scoring Scheme. Classification of cases was by allergological workup based on immediate and delayed investigations. The discrimination and calibration of the Hypersensitivity Clinical Scoring Scheme was compared with results from an expert panel of allergologists, skin testing, mast cell tryptase ratios, and specific IgE assays, as was agreement by Cohen's kappa coefficient., Results: The Hypersensitivity Clinical Scoring Scheme predicted cases of allergic perioperative immediate hypersensitivity reaction with comparable discrimination to an expert panel, mast cell tryptase formula, and specific IgE assays in anaphylaxis to neuromuscular blocking drugs. Using a score threshold of 15 or greater to indicate allergic perioperative immediate hypersensitivity reaction, the sensitivity was 88.9%, with a specificity of 79.4%. Prospectively, the Hypersensitivity Clinical Scoring Scheme correctly classified a greater number of subjects than the expert panel and the optimal post hoc binary logistic regression model (86% vs 85% vs 84%), however it was inferior to skin testing., Conclusion: The Hypersensitivity Clinical Scoring Scheme predicts allergic perioperative immediate hypersensitivity using features of the acute syndrome. This approach could guide algorithms for the post-resuscitative management of suspected perioperative immediate hypersensitivity, and identify patients requiring drug provocation challenge., Competing Interests: Declarations of interest The authors declare that they have no conflicts of interest., (Copyright © 2022 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
5. Detection of drug-specific immunoglobulin E (IgE) and acute mediator release for the diagnosis of immediate drug hypersensitivity reactions.
- Author
-
Brockow K
- Subjects
- Animals, Antibody Specificity, Basophils immunology, Basophils metabolism, Biomarkers blood, Drug Hypersensitivity blood, Drug Hypersensitivity immunology, Humans, Hypersensitivity, Immediate blood, Hypersensitivity, Immediate immunology, Mast Cells immunology, Mast Cells metabolism, Predictive Value of Tests, Risk Factors, Basophils drug effects, Cell Degranulation drug effects, Drug Hypersensitivity diagnosis, Histamine Release drug effects, Hypersensitivity, Immediate diagnosis, Immunoglobulin E blood, Immunologic Tests, Mast Cells drug effects
- Abstract
The diagnosis of a drug hypersensitivity reaction (DHR) is complex. The first step after taking the clinical history is to look for a sensitization to confirm or exclude the diagnosis and to identify the culprit drug. Skin tests are the primary means of detecting sensitization in DHR, but are associated with a risk for a severe reaction and may be contraindicated. In vitro tests offer the potential to support or confirm a diagnosis of DHR and influence medical decision making. For immediate-type DHR, a few validated assays for measurement of specific IgE (sIgE) are commercially available to a limited number of drugs. In addition, several home-made sIgE radioimmunoassays have been used in other studies. The sensitivity of the sIgE assay is drug-dependant and generally low (0-85%) for betalactams and reported heterogeneous for other drugs ranging from 26% for chlorhexidine and 44% for suxamethonium to 92% for chlorhexidine. However, as all these studies included patients, in whom DHR was confirmed only by skin tests and not by provocation, the results have to be interpreted carefully and may be unreliable. Determination of mediators during an acute phase of a reaction may indirectly support the diagnosis of a DHR by demonstrating mast cell and basophil mediator release. Negative in vitro tests do not exclude a DHR or imputability of a drug, but a positive result may support causality and eliminate the necessity for a drug provocation test. Unfortunately, evidence is limited with a lack of well-controlled studies in larger numbers of well-phenotyped patients, which results in susceptibility for bias and a need for future multicenter studies., (Copyright © 2021. Published by Elsevier B.V.)
- Published
- 2021
- Full Text
- View/download PDF
6. Mast cell activation test in chlorhexidine allergy: a proof of concept.
- Author
-
Elst J, van der Poorten MM, Faber MA, Van Gasse AL, Garvey LH, Bridts CH, De Puysseleyr LP, Mertens C, Hagendorens MM, Sabato V, and Ebo DG
- Subjects
- Adult, Aged, Chlorhexidine immunology, Drug Hypersensitivity immunology, Female, Humans, Hypersensitivity, Immediate immunology, Male, Mast Cells metabolism, Middle Aged, Chlorhexidine adverse effects, Drug Hypersensitivity blood, Drug Hypersensitivity diagnosis, Hypersensitivity, Immediate blood, Hypersensitivity, Immediate diagnosis, Mast Cells immunology
- Abstract
Background: Immediate drug hypersensitivity reactions are an increasing public health issue and a frequent cause of life-threatening anaphylaxis. Conventional confirmatory testing include skin tests and, for a few drugs, quantification of drug-specific immunoglobulin E (IgE) antibodies. However, none of these tests are absolutely predictive for the clinical outcome, and can yield false-negative and false-positive results. We performed a proof-of-concept study to assess whether a mast cell activation test could improve diagnosis of IgE-mediated chlorhexidine hypersensitivity, a common cause of perioperative anaphylaxis., Methods: Human mast cells were generated from CD34
+ progenitor cells and sensitised with patients' sera to become IgE+ human mast cells (dMCIgE+ ), and then incubated with chlorhexidine to assess degranulation. We compared the diagnostic performance of this mast cell activation test with serum from patients with and without positive skin test and basophil activation test to chlorhexidine., Results: In dMC sensitised with sera from patients with a positive skin test and basophil activation test to chlorhexidine showed drug-specific and concentration-dependent degranulation upon stimulation with chlorhexidine, determined by surface upregulation of the degranulation marker CD63. In contrast, dMC sensitised with sera from patients with a negative skin test and basophil activation test to chlorhexidine were unresponsive in the mast cell activation test., Conclusions: Our study suggests that the mast cell activation test can be used to diagnose IgE/FcεRI-dependent immediate drug hypersensitivity reactions. It also shows potential to assess the clinical relevance of drug-specific IgE antibodies in their ability to elicit mast cell degranulation, and therefore discriminate between allergy and sensitisation. Extended studies are required to verify whether this technique can be used in other causes of perioperative anaphylaxis., (Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)- Published
- 2020
- Full Text
- View/download PDF
7. Serum specific IgE antibodies in immediate drug hypersensitivity.
- Author
-
van der Poorten MM, Van Gasse AL, Hagendorens MM, Faber MA, De Puysseleyr L, Elst J, Mertens CM, Sabato V, and Ebo DG
- Subjects
- Humans, Immunoglobulin E, Skin Tests, Anaphylaxis, Drug Hypersensitivity diagnosis, Hypersensitivity, Immediate chemically induced, Hypersensitivity, Immediate diagnosis
- Abstract
Immediate drug hypersensitivity reactions (IDHRs) constitute a significant health problem that may be compounded by consequences of diagnostic error. In daily practice, IDHR diagnostic work up starts with drug-specific skin testing and/or quantification of specific IgE (sigE) antibodies in serum. Here we critically review the performance, i.e. potential and limitations of sIgE to β-lactam antibiotics (β-LABs), curarizing neuromuscular blocking agents (NMBAs), opiates and (semi)synthetic opioids, fluoroquinolones (FQs), poppy seed (papaver somniferum), chlorhexidine and finally Hevea latex. Quintessence of these studies is clear. Quantification of these drug-specific sIgE should not be used in isolation to document or exclude diagnosis of an IDHR. False negative results entail the risk for subsequent potentially life-threatening anaphylaxis upon re-exposure. False positive results lead to erroneous avoidance and unnecessary substitutions and fails to identify the true etiology., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020. Published by Elsevier B.V.)
- Published
- 2020
- Full Text
- View/download PDF
8. In vitro diagnostic tests for perioperative hypersensitivity, a narrative review: potential, limitations, and perspectives.
- Author
-
Takazawa T, Sabato V, and Ebo DG
- Subjects
- Humans, Drug Hypersensitivity diagnosis, Hypersensitivity, Immediate diagnosis, In Vitro Techniques methods
- Abstract
Correct diagnostic management of perioperative hypersensitivity aims to identify the underlying mechanism(s), responsible culprit(s), and safe alternative drugs or techniques. Although drug provocation tests are considered the gold standard, diagnosis of perioperative hypersensitivity mainly relies on skin testing. Use of in vitro tests, such as quantification of specific immunoglobulin E antibodies, serum tryptase, and plasma histamine, as well as basophil activation tests is becoming widespread. These latter tests have the advantage of having no risk of recurrence of immediate hypersensitivity reactions. In this narrative review, we summarise the principles of these in vitro tests, and the possibilities and limitations when these tests are used for testing sensitivity to substances with a high risk of causing perioperative hypersensitivity. Hence, we focus on neuromuscular blocking agents, antibiotics, natural rubber latex, and opiates/opioids. The combination of multiple tests would allow diagnosis of perioperative hypersensitivity with the right balance of safety and accuracy., (Copyright © 2019 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
9. Immediate-type allergic reactions to local anesthetics.
- Author
-
Nakamura N, Tamagawa-Mineoka R, Masuda K, and Katoh N
- Subjects
- Humans, Skin Tests, Anesthetics, Local adverse effects, Drug Hypersensitivity diagnosis, Drug Hypersensitivity etiology, Hypersensitivity, Immediate diagnosis, Hypersensitivity, Immediate etiology
- Published
- 2018
- Full Text
- View/download PDF
10. Quantification of specific IgE antibodies in immediate drug hypersensitivity: More shortcomings than potentials?
- Author
-
Decuyper II, Ebo DG, Uyttebroek AP, Hagendorens MM, Faber MA, Bridts CH, De Clerck LS, and Sabato V
- Subjects
- Biomarkers blood, Drug Hypersensitivity blood, Drug Hypersensitivity immunology, Humans, Hypersensitivity, Immediate blood, Hypersensitivity, Immediate immunology, Sensitivity and Specificity, Drug Hypersensitivity diagnosis, Hypersensitivity, Immediate diagnosis, Immunoglobulin E blood
- Abstract
Background: For many physicians, quantification of serum drug-specific IgE (sIgE) antibodies constitutes the first measure in the diagnostic approach of immediate drug hypersensitivity reactions (IDHR)., Aim: To review the accuracy and limitations of the main drug-sIgE tests, especially those that are commercially available., Methods: A literature search was conducted, using the key-words allergy, diagnosis, drugs, hypersensitivity, specific IgE antibodies; this was complemented by the authors' own experience., Results: The drugs that have mostly been studied appeared to be β-lactam antibiotics, neuromuscular blocking agents (NMBA) and morphine, the latter as a biomarker for sensitisation to substituted ammonium structures that constitute the major epitope of NMBA. For β-lactams sensitivity and specificity varied between 0-85% and 52-100%, respectively. For NMBA, sensitivity and specificity varied between 38.5-92% and 92-100%, respectively. With respect to sIgE to morphine it appears this drug to be a sensitive biomarker for sensitisation to rocuronium and suxamethonium but not for atracurium. However, sIgE morphine should not be applied in isolation to diagnose IDHR to NMBA nor opiates., Conclusions: Although drug-sIgE assay can provide valuable information they should not be performed in isolation to establish correct diagnosis, as their predictive value is not per se absolute. Larger comprehensive studies are urgently required to determine the accuracy of drug-sIgE assays., (Copyright © 2016. Published by Elsevier B.V.)
- Published
- 2016
- Full Text
- View/download PDF
11. Antibiotic-induced immediate type hypersensitivity is a risk factor for positive allergy skin tests for neuromuscular blocking agents.
- Author
-
Hagau N, Gherman N, Cocis M, and Petrisor C
- Subjects
- Anti-Bacterial Agents administration & dosage, Case-Control Studies, Female, Humans, Male, Neuromuscular Blocking Agents administration & dosage, Risk Factors, Anti-Bacterial Agents adverse effects, Cross Reactions, Drug Hypersensitivity diagnosis, Drug Hypersensitivity immunology, Hypersensitivity, Immediate immunology, Neuromuscular Blocking Agents adverse effects, Skin Tests
- Abstract
Background: Skin tests for neuromuscular blocking agents (NMBAs) are not currently recommended for the general population undergoing general anaesthesia. In a previous study we have reported a high incidence of positive allergy tests for NMBAs in patients with a positive history of non-anaesthetic drug allergy, a larger prospective study being needed to confirm those preliminary results. The objective of this study was to compare the skin tests results for patients with a positive history of antibiotic-induced immediate type hypersensitivity reactions to those of controls without drug allergies., Methods: Ninety eight patients with previous antibiotic hypersensitivity and 72 controls were prospectively included. Skin tests were performed for atracurium, pancuronium, rocuronium, and suxamethonium., Results: We found 65 positive skin tests from the 392 tests performed in patients with a positive history of antibiotic hypersensitivity (1 6.58%) and 23 positive skin tests from the 288 performed in controls (7.98%), the two incidences showing significant statistical difference (p = 0.0011). The relative risk for having a positive skin test for NMBAs for patients versus controls was 1.77 (1.15-2.76). For atracurium, skin tests were more often positive in patients with a positive history of antibiotic hypersensitivity versus controls (p = 0.02). For pancuronium, rocuronium and suxamethonium the statistical difference was not attained (p-values 0.08 for pancuronium, 0.23 for rocuronium, and 0.26 for suxamethonium)., Conclusions: Patients with a positive history of antibiotic hypersensitivity seem to have a higher incidence of positive skin tests for NMBAs. They might represent a group at higher risk for developing intraoperative anaphylaxis compared to the general population., (Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
12. IgE to penicillins with different specificities can be identified by a multiepitope macromolecule: Bihaptenic penicillin structures and IgE specificities.
- Author
-
Ariza A, Barrionuevo E, Mayorga C, Montañez MI, Perez-Inestrosa E, Ruiz-Sánchez A, Rodríguez-Guéant RM, Fernández TD, Guéant JL, Torres MJ, and Blanca M
- Subjects
- Adolescent, Adult, Aged, Amoxicillin adverse effects, Antibody Affinity immunology, Antibody Specificity immunology, Drug Hypersensitivity immunology, Epitopes immunology, Female, Haptens immunology, Humans, Hypersensitivity, Immediate immunology, Immunoassay methods, Male, Middle Aged, Penicillin G adverse effects, Penicillins adverse effects, Penicillins immunology, Radioallergosorbent Test methods, Skin Tests, Young Adult, beta-Lactams adverse effects, beta-Lactams immunology, Amoxicillin immunology, Drug Hypersensitivity diagnosis, Hypersensitivity, Immediate diagnosis, Immunoglobulin E blood, Penicillin G immunology
- Abstract
Quantitation of specific IgE by immunoassay is a recommended in vitro test for the diagnosis of immediate hypersensitivity reactions to betalactams (BLs), particularly when skin test results are negative. IgE antibodies that recognize the common nuclear structure of all BLs or the specific side chain structure can be mainly distinguished by immunoassays. The aim of this study was to develop an immunoassay system to detect IgE antibodies with different specificities. Cellulose discs conjugated with benzylpenicillin (BP), amoxicillin (AX) or both drugs, with poly-l-lysine (PLL) as carrier molecule, were used as solid phases in the radioallergosorbent test (RAST). Direct and inhibition radioimmunoassay studies were made to verify the structures recognized by serum IgE antibodies from penicillin-allergic patients. Our results indicated that the addition of both haptens did not decrease the capacity to capture IgE when serum specific to either BP or AX was used, at least in terms of sensitivity. In addition, the inclusion of two haptens improved significantly the levels of IgE detection in patients who recognized both BP and AX. Therefore, the use of a solid phase with a carrier molecule conjugated with two determinants (AX and BP) is helpful to recognize IgE antibodies against either of these determinants and is useful for screening sera with different specificities., (Copyright © 2014 Elsevier B.V. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
13. Positive skin prick test to cefcapene pivoxil hydrochloride hydrate: a case report.
- Author
-
Yamazato S, Nakai N, and Katoh N
- Subjects
- Aged, Anti-Bacterial Agents administration & dosage, Cephalosporins administration & dosage, Drug Hypersensitivity etiology, Humans, Hypersensitivity, Immediate etiology, Male, Skin Tests, Anti-Bacterial Agents adverse effects, Cephalosporins adverse effects, Drug Hypersensitivity diagnosis, Hypersensitivity, Immediate diagnosis
- Published
- 2013
- Full Text
- View/download PDF
14. [Immediate hypersensitivity to cisatracurium. Value of skin tests].
- Author
-
Monnin M, Lonjaret L, Fourcade O, and Geeraerts T
- Subjects
- Anesthesia, Brain Neoplasms surgery, Humans, Male, Middle Aged, Atracurium analogs & derivatives, Drug Hypersensitivity diagnosis, Hypersensitivity, Immediate diagnosis, Neuromuscular Nondepolarizing Agents, Skin Tests
- Published
- 2012
- Full Text
- View/download PDF
15. [Control of the biological diagnostic assessment. Immunoglobulin E].
- Author
-
Guilloux L, Benoit Y, Aimone-Gastin I, Ponvert C, and Beaudouin E
- Subjects
- Anaphylaxis chemically induced, Anaphylaxis prevention & control, Anesthetics adverse effects, Anesthetics immunology, Anti-Bacterial Agents adverse effects, Anti-Bacterial Agents immunology, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Anti-Inflammatory Agents, Non-Steroidal immunology, Antibody Specificity, Contrast Media adverse effects, Cross Reactions, Drug Hypersensitivity etiology, Drug Hypersensitivity immunology, Humans, Hypersensitivity, Immediate chemically induced, Hypersensitivity, Immediate immunology, Hypnotics and Sedatives adverse effects, Hypnotics and Sedatives immunology, Immunoglobulin E immunology, Intraoperative Complications chemically induced, Intraoperative Complications prevention & control, Latex Hypersensitivity diagnosis, Latex Hypersensitivity immunology, Narcotics adverse effects, Narcotics immunology, Neuromuscular Nondepolarizing Agents adverse effects, Neuromuscular Nondepolarizing Agents immunology, Reproducibility of Results, Sensitivity and Specificity, Sepharose, Drug Hypersensitivity diagnosis, Hypersensitivity, Immediate diagnosis, Immunoglobulin E analysis, Immunoradiometric Assay methods, Radioallergosorbent Test methods
- Published
- 2011
- Full Text
- View/download PDF
16. [Allergologic screening and management of patients with previous self-reported hypersensitivity reactions. Société française d'anesthésie et réanimation. Société française d'allergologie].
- Author
-
Moneret-Vautrin DA, Codreanu F, Drouet M, Plaud B, Karila C, Valfrey J, Debaene B, Malinovsky JM, and Mertes JM
- Subjects
- Anaphylaxis chemically induced, Anesthetics adverse effects, Anti-Bacterial Agents adverse effects, Anti-Bacterial Agents classification, Case-Control Studies, Contrast Media adverse effects, Disease Management, Drug Hypersensitivity etiology, Elective Surgical Procedures, Female, Food Hypersensitivity diagnosis, Food Hypersensitivity etiology, Humans, Hypersensitivity, Immediate chemically induced, Hypnotics and Sedatives adverse effects, Intraoperative Complications chemically induced, Latex Hypersensitivity diagnosis, Male, Meta-Analysis as Topic, Narcotics adverse effects, Neuromuscular Nondepolarizing Agents adverse effects, Pregnancy, Pregnancy Complications chemically induced, Pregnancy Complications immunology, Pregnancy Complications prevention & control, Respiratory Hypersensitivity diagnosis, Respiratory Hypersensitivity etiology, Anaphylaxis prevention & control, Diagnostic Self Evaluation, Drug Hypersensitivity diagnosis, Hypersensitivity, Immediate diagnosis, Intraoperative Complications prevention & control, Preoperative Care standards
- Published
- 2011
- Full Text
- View/download PDF
17. The incremental challenge test in the diagnosis of adverse reactions to local anesthetics.
- Author
-
Nettis E, Napoli G, Ferrannini A, and Tursi A
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Chi-Square Distribution, Child, Child, Preschool, Drug Hypersensitivity etiology, Female, Humans, Hypersensitivity, Immediate chemically induced, Immunoglobulin E immunology, Male, Middle Aged, Reproducibility of Results, Sensitivity and Specificity, Anesthetics, Local adverse effects, Drug Hypersensitivity diagnosis, Hypersensitivity, Immediate diagnosis, Skin Tests methods
- Abstract
Objective: The aim of this study was to assess the reliability of a diagnostic protocol, the incremental challenge test (ICT), for patients with and without a history of adverse reactions to local anesthetics (LAs) or other drugs, to select an LA that could be safely used., Study Design: The ICT was performed on 432 subjects, 314 female and 118 male. Four hundred thirty-two challenges were carried out with LAs that were free of adrenaline and preservatives. Chi-square analysis was performed to evaluate the existence of different predispositions to ICT positivity among subjects of the 4 categories studied., Results: Four hundred fifteen tests were completed with no clinical events occurring. The analysis did not show any significant difference (chi-square = 6.17; P >.05)., Conclusions: Our results confirm that immunoglobulin E-mediated reactions to LAs are uncommon and that the ICT offers safety and specificity in diagnosing adverse reactions to LAs, allowing for the selection of a safe and reliable LA.
- Published
- 2001
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.