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Drug hypersensitivity in children: a retrospective analysis of 101 pharmacovigilance reports

Abstract : Our objective was to describe and discuss management of recent cases of drug hypersensitivity in children reported in a pharmacovigilance center. Two pediatric allergy units conducted a collaborative retrospective analysis of 101 adverse drug reactions reported to a regional pharmacovigilance center between January 2016 and July 2019. Time lapse between hypersensitivity reaction onset and allergy consultation varied from 1 month to 12 years. Sixty-two patients (61.4%) presented with immediate reactions, 11 (10.9%) with non-immediate reactions, and 28 (27.7%) had reactions impossible to classify through medical interview. Overall, 92 children (91%) were explored for simultaneously administered drugs. All 113 prick tests were negative, and 2 were uncertain. Among 108 intradermal tests, 2 were positive to penicillin and to an iodinated contrast medium, 105 were negative, and 1 was uncertain. Overall, 129 drug provocation tests were proposed. Nine provocation tests among 80 were positive (11.25%): 6 to penicillin, 1 to sulfonamide antibiotics, and 2 to non-steroidal anti-inflammatory drugs; the remaining 71 were negative. No severe reaction was observed during these tests. Finally, drug allergy was only retained in 11 reported cases (10.9%). Conclusion: These pharmacovigilance reports show the difficulty in defining drug allergy in children only by anamnesis, and that explorations, particularly provocation tests, should take place at a reasonable time lapse after drug hypersensitivity reaction onset. What is Known: True drug allergy is rarely observed in children. Absence of full workup leads to falsely labeling children as ``allergic.'' What is New: Short time lapse between hypersensitivity onset and consultation improves classification of pediatric allergy. Timely allergy consultations are essential, and tests are useful to confirm or exclude pediatric allergy.
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https://hal-amu.archives-ouvertes.fr/hal-03149251
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Submitted on : Monday, February 22, 2021 - 8:01:53 PM
Last modification on : Friday, April 1, 2022 - 3:44:08 AM

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Maria Katsogiannou, Ania Carsin, Julie Mazenq, Jean-Christophe Dubus, Marie-Jose Gervoise-Boyer. Drug hypersensitivity in children: a retrospective analysis of 101 pharmacovigilance reports. European journal of pediatrics, 2021, 180 (2), pp.495-503. ⟨10.1007/s00431-020-03859-2⟩. ⟨hal-03149251⟩

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