Drug-Induced Anaphylaxis

Immunol Allergy Clin North Am. 2017 Nov;37(4):629-641. doi: 10.1016/j.iac.2017.06.002. Epub 2017 Aug 9.

Abstract

Drugs are among the main triggers of anaphylaxis, but identification of the culprit drug is frequently difficult. To confirm diagnosis of the causative agent, medical records and clinical history are fundamental. There are a few in vitro tests available in clinical practice, such as serum-specific IgE and basophil activation test. Skin tests are often useful for the diagnosis, although drug challenge is indicated in patients with inconclusive clinical history or to provide safe alternatives. Treatment of anaphylaxis is standard and intramuscular epinephrine is the main agent to prevent morbidity and mortality. Rapid desensitization may be indicated in selected cases.

Keywords: Adverse drug reactions; Anaphylaxis; Drug allergy; Epinephrine; Hypersensitivity; Nonsteroidal anti-inflammatory drugs.

Publication types

  • Review

MeSH terms

  • Anaphylaxis / diagnosis*
  • Anaphylaxis / drug therapy
  • Anaphylaxis / epidemiology
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Diagnosis, Differential
  • Drug Hypersensitivity / diagnosis*
  • Drug Hypersensitivity / drug therapy
  • Drug Hypersensitivity / epidemiology
  • Epinephrine / therapeutic use
  • Humans
  • Immunoglobulin E / metabolism
  • Mastocytosis, Systemic / diagnosis*
  • Practice Guidelines as Topic
  • Prevalence

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Immunoglobulin E
  • Epinephrine