Original Articles: Systemic Allergic DisordersMultiple-drug intolerance syndrome: clinical findings and usefulness of challenge tests
Section snippets
INTRODUCTION
Adverse drug reactions are common in clinical practice. They have been estimated to cause 3% to 8% of hospital admissions.1, 2, 3 Drug hypersensitivity is responsible for 30% to 40% of cases. Among these, only a few are attributable to an immune-allergic mechanism (usually type I and IV and more rarely type II and III immunoreactions), whereas in most cases results of allergy testing, including skin prick and patch tests and measurement of specific IgE levels in serum, are negative. The
METHODS
We studied 480 patients (aged >16 years) who visited the Allergy Unit between January 1, 2000, and December 31, 2005, with a history of adverse reactions to at least 3 chemically and pharmacodynamically unrelated drugs and with negative allergy test results. Thirty patients had chronic urticaria. Symptoms were directly correlated with drug intake as documented in an emergency service record or a certificate from a general practitioner. The number of reactions and symptoms for each episode were
General Characteristics of the Study Population
Of 480 patients studied, 405 were female (84.4%) and 75 were male (15.6%) (age range, 17-83 years). A detailed distribution of patients in the various age ranges is reported in Figure 1. Family and personal histories of atopic diseases were detected in 19.8% and 10.8% of patients, respectively; in particular, rhinitis (13.8%), asthma (3.7%), and urticaria (11.0%) were detected in the personal history of the patients.
Drugs Involved
A total of 2,380 reactions were reported involving 286 identified molecules; in
DISCUSSION
As stated in some previous studies5, 6 females are more involved (77.5% of cases) than males, with prevalence in the fourth to sixth decades of life. Familial history was positive for atopy in 19.8% of patients and for adverse drug reactions (drug intolerance) in 13.3%. A personal history of atopy does not seem to be a risk factor because just 10.8% of the patients were involved.
Concomitant respiratory or food allergy should be considered a predisposing factor, as indicated in some studies.16
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Authors have nothing to disclose.