Back to Search
Start Over
Epidemiology, Mechanisms, and Diagnosis of Drug-Induced Anaphylaxis
- Source :
- Frontiers in Immunology, Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid, Consejería de Sanidad de la Comunidad de Madrid, Frontiers in Immunology, Vol 8 (2017)
- Publication Year :
- 2017
- Publisher :
- Frontiers Media S.A., 2017.
-
Abstract
- 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.
- Subjects :
- 0301 basic medicine
lcsh:Immunologic diseases. Allergy
IgG
Mini Review
Provocation test
Immunology
Tryptase
Immunoglobulin E
drugs
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
medicine
anaphylaxis
Immunology and Allergy
biology
business.industry
fungi
Degranulation
MAS-related G protein-coupled receptor
food and beverages
medicine.disease
in vivo diagnosis
Basophil activation
030104 developmental biology
030228 respiratory system
chemistry
in vitro tests
biology.protein
IgE
Antibody
business
lcsh:RC581-607
Anaphylaxis
Histamine
Subjects
Details
- Language :
- English
- ISSN :
- 16643224
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Frontiers in Immunology
- Accession number :
- edsair.doi.dedup.....1a97d9586534355bac2c32dc75a614b7
- Full Text :
- https://doi.org/10.3389/fimmu.2017.00614