Skin tests and challenge-based drug allergy diagnosis: a retrospective study of patients with confirmed drug allergy
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Authors Information
1CINTESIS, Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal
2Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
3MEDIDA, Lda, Porto, Portugal 4Basic and Clinical Immunology, Pathology Department, Faculty of Medicine, University of Porto, Porto, Portugal
History
Published online: 03 October 2019
Accepted: 26 June 2019
Received: 05 May 2019
SUMMARY
Objectives. To describe clinical manifestations and performed diagnostic workup, focusing drug challenge tests (DCT), in patients with drug allergy. Methods. Retrospective study including all patients with skin tests (STs) or DCT-based drug allergy diagnosis, between 01/2014 – 06/2018 in a Portuguese allergy unit. Data were collected from electronic and paper-based clinical records. Results. We had 75 drug allergy diagnoses. Most index reactions were mild and major or equal 1 hour after drug intake. 59 (78%) diagnoses were based on DCTs, all based on multistep protocols with major or equal 3 predicted steps. Only 10% of the DCT were positive during up-dosing; timing and severity of the index reaction predicted DCT interruption during up-dosing. Conclusions. Most drug allergy diagnoses were based on multistep DCT. The identified predictors of DCT interruption during up-dosing can support the development of more personalized DCTs protocols.
