The Value of In Vitro Tests to DiminishDrug Challenges.

Drug hypersensitivity reactions have multiple implications for patient safety and health system costs, thus it is important to perform an accurate diagnosis. The diagnostic procedure includes a detailed clinical history, often unreliable; followed by skin tests, sometimes with low sensitivity or una...

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Bibliographic Details
Authors: Mayorga, Cristobalina, Doña, Inmaculada, Perez-Inestrosa, Ezequiel, Fernández, Tahia D, Torres, Maria J
Format: article
Publication Date:2017
Country:España
Institution:Instituto de Salud Carlos III (ISCIII)
Repository:Repisalud
Language:English
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/17316
Online Access:http://hdl.handle.net/20.500.12105/17316
Access Level:Open access
Keyword:IgE
T-cells
allergy
basophils
cytokines
diagnosis
drug
hypersensitivity
immunoassays
in vitro
Diagnostic Tests, Routine
Drug Hypersensitivity
Humans
Hypersensitivity, Delayed
Hypersensitivity, Immediate
Immunoglobulin E
T-Lymphocytes
Description
Summary:Drug hypersensitivity reactions have multiple implications for patient safety and health system costs, thus it is important to perform an accurate diagnosis. The diagnostic procedure includes a detailed clinical history, often unreliable; followed by skin tests, sometimes with low sensitivity or unavailable; and drug provocation testing, which is not risk-free for the patient, especially in severe reactions. In vitro tests could help to identify correctly the responsible agent, thus improving the diagnosis of these reactions, helping the physician to find safe alternatives, and reducing the need to perform drug provocation testing. However, it is necessary to confirm the sensitivity, specificity, negative and positive predictive values for these in vitro tests to enable their implementation in clinical practice. In this review, we have analyzed these parameters from different studies that have used in vitro test for evaluating drug hypersensitivity reactions and estimated the added value of these tests to the in vivo diagnosis.