October 2, 2015

Drug Hypersensitivity in children: report from the pediatric task force of the EAACI Drug Allergy Interest Group

  1. Eva Gomes1,*
  2. Knut Brockow2
  3. Semanur Kuyucu3
  4. Francesca Saretta4
  5. Francesca Mori5
  6. Natalia Blanca-Lopez6
  7. Hagen Ott7,
  8. Marina Atanaskovic-Markovic8
  9. Mona Kidon9
  10. Jean-Christoph Caubet10
  11. Ingrid Terreehorst11 and
  12. The ENDA/EAACI Drug Allergy Interest Group
Allergy

Abstract: When questioned, about 10% of the parents report suspected hypersensitivity to at least one drug in their children. However, only a few of these reactions can be confirmed as allergic after a diagnostic workup. There is still a lack of knowledge on drug hypersensitivity epidemiology, clinical spectrum and appropriate diagnostic methods particularly in children. Meanwhile, the tools used for drug hypersensitivity management in adults are applied also for children. Whereas this appears generally acceptable, some aspects of drug hypersensitivity and management differ with age. Most reactions in children are still attributed to betalactams. Some manifestations, such as non-steroidal anti-inflammatory drug-associated angioedema and serum sickness-like reactions are more frequent among young patients as compared to adults. Risk factors such as viral infections are particularly frequent in children, making the diagnosis challenging. The practicability and validity of skin test and other diagnostic procedures need further assessment in children. This paper presents an up-to-date review on epidemiology, clinical spectrum, diagnostic tools and current management of drug hypersensitivity in children. A new general algorithm for the study of these reactions in children is proposed. Data are presented focusing on reported differences between pediatric and adult patients, also identifying unmet needs to be addressed in further research.

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