Oral challenge to drugs in pediatrics – casuistry 2015

Authors

  • Mónica André Costeira Department of Pediatrics, Hospital da Senhora da Oliveira
  • Dinis Sousa Department of Pediatrics, Hospital da Senhora da Oliveira
  • Joana Ferreira Department of Pediatrics, Hospital da Senhora da Oliveira
  • Carla Ferreira Department of Pediatrics, Hospital da Senhora da Oliveira
  • Armandina Silva Department of Pediatrics, Hospital da Senhora da Oliveira
  • Marta Santalha Department of Pediatrics, Hospital da Senhora da Oliveira
  • Paula Alendouro Department of Immunoallergology, Hospital da Senhora da Oliveira
  • Águeda Matos Department of Pediatrics, Hospital da Senhora da Oliveira
  • Alberto Costa Department of Pediatrics, Hospital da Senhora da Oliveira

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v26.i4.9865

Keywords:

Allergy, drugs, oral challenge

Abstract

Introduction: Suspected drug allergy in the pediatric population is a frequent reason for consultation. However, it is rarely confirmed. Thus, the oral challenge (OC) assumes a significant role in the diagnostic approach.
Objectives: Characterize a pediatric population of a level II hospital submitted to OC to drugs, assess which drugs where implicated and analyze the cases in which the OC was positive.
Materials and methods: Clinical records of the patients submitted to OC to drugs in the period of January 1st to December 31st 2015, younger than 18 years.
Results: The sample included 58 patients, 53.4% male. The median age was five years. Most were referred from the emergency room (39.7%) and the outpatient clinic (36.2%). Amoxicillin was the suspected drug in 46.6% and when associated with clavulanic acid in 34.5%. About 93.1% had mucocutaneous manifestations, 5.2% gastrointestinal and mucocutaneous and 1.7% respiratory and mucocutaneous. In 20.7% of the cases, symptoms occurred during the first 24 hours. In three patients the OC was positive and the responsible drug was amoxicillin in two cases and ibuprofen in one.
Conclusions: Allergy to drugs is rare in children but, considering its relevance in the management of infectious situations, it becomes important to refer all suspected cases to clarify the diagnosis.

Author Biography

Mónica André Costeira, Department of Pediatrics, Hospital da Senhora da Oliveira

Interna de Pediatria Médica no Hospital Senhora da Oliveira, Guimarães

References

KGomes ER, Brockow K, Kuyucu S, Saretta F, Mori F, Blanca-Lopez N et al. Drug hypersensivity in children: report from the pediatric task force of the EAACI Drug Allergy Interest Group. Allergy 71. 2016; 149-61.

Park MA, Koch CA, Klemawesch P, Joshi A, Li JT. Increased adverse drug reactions to cephalosporins in penicilin allergy patients with positive penicillin skin test. Int Arch Allergy Immunol. 2010; 153:268-73.

Blanca M, Romano A, Torres MJ, Férnandez J, Mayorga C, Rodriguez J et al. Update on the evaluation of hypersensitivity reactions to betalactams. Allergy 2009; 64:183–93.

Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA et al. International Consensus on drug allergy. Allergy 69. 2014: 420-37.

Mayorga C, Celik G, Rouzaire P, Whitaker P, Bonadonna P, Rodrigues-Cernadas J et al. In vitro tests for drug hypersensitivity reactions na ENDA/ EAACI Drug Allergy Interest Group position paper. Allergy 2016; doi: 10.1111/all.12886.

Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P et al. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy 2002; 57:45-51.

Romano A, Blanca M, Torres MJ, Bircher A, Aberer W, Brockow K et al. Diagnosis of non imediate reactions to beta-lactam antibiotics. Allergy 2004; 59:1153-60.

Demoly P, Romano A, Botelho C, Bousquet-Rouanet L, Gaeta F, Silva R et al. Determining the negative predictive value of provocation tests with beta-lactams. Allergy 65. 2010; 327-32.

Published

2017-12-27

How to Cite

Costeira, M. A., Sousa, D., Ferreira, J., Ferreira, C., Silva, A., Santalha, M., Alendouro, P., Matos, Águeda, & Costa, A. (2017). Oral challenge to drugs in pediatrics – casuistry 2015. NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 26(4), 216–220. https://doi.org/10.25753/BirthGrowthMJ.v26.i4.9865

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Section

Original Articles

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