Benahmed Said, Picot Marie Christine, Hillaire-Buys Dominique, Blayac Jean Pierre, Dujols Pierre, Demoly Pascal
Exploration des Allergies-Maladies Respiratoires, INSERM U454-IFR3, Hôpital Arnaud de Villeneuve, CHU Montpellier, 34295 Montpellier Cedex 5, France.
Eur J Clin Pharmacol. 2005 Aug;61(7):537-41. doi: 10.1007/s00228-005-0962-1. Epub 2005 Jul 15.
A firm diagnosis of drug hypersensitivity, because it may re-induce the reaction, is seldom confirmed. Causality assessment algorithms are therefore of interest.
The objective of this work was to compare three algorithms in the diagnosis of drug hypersensitivity.
Evaluation of 120 clinical histories of drug hypersensitivity was carried out: 60 involving beta-lactams (50%) and 60 involving non-steroidal anti-inflammatory drugs (50%). Each of these groups of patients underwent a standardised allergy diagnosis, which included a detailed anamnesis, skin tests and, often, provocation tests under strict hospital surveillance. Unaware of the final allergy diagnosis, scores were established for all of the cases and compared using algorithms suggested by Begaud and coworkers [2, 20], Jones [13] and Naranjo et al. [21].
Although the methods of Jones [13] and Naranjo et al. [21] were perfectly concordant (k=1), no concordance was noted using the Begaud and coworkers [2, 20] method.
All three algorithms are dissimilar regarding the diagnosis of drug hypersensitivity.
由于药物超敏反应的确诊可能会再次引发该反应，所以很少能得到确切诊断。因此，因果关系评估算法备受关注。
本研究的目的是比较三种算法在药物超敏反应诊断中的应用。
对120例药物超敏反应的临床病史进行了评估：其中60例涉及β-内酰胺类药物（50%），60例涉及非甾体类抗炎药（50%）。每组患者均接受了标准化的过敏诊断，包括详细的问诊、皮肤试验，并且在严格的医院监测下，通常还进行激发试验。在不知道最终过敏诊断结果的情况下，为所有病例打分，并使用Begaud及其同事[2, 20]、Jones[13]和Naranjo等人[21]建议的算法进行比较。
尽管Jones[13]和Naranjo等人[21]的方法完全一致（k = 1），但使用Begaud及其同事[2, 20]的方法时未发现一致性。
在药物超敏反应的诊断方面，这三种算法均不相同。
