Allergy Department and INSERM U657, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France.
Clin Exp Allergy. 2012 Jan;42(1):123-30. doi: 10.1111/j.1365-2222.2011.03887.x. Epub 2011 Oct 13.
Proven IgE or T-cell mediated drug hypersensitivity reactions (DHRs) seem less common in children compared with adults. However, this has never been proved by data.
To determine and compare proven DHR prevalence in children and adults.
Using the DAHD (Drug Allergy and Hypersensitivity Database) cohort, children with proven DHRs were compared with adults. The international EAACI-ENDA recommendations were followed. Patients were divided into four groups: index reaction and test during childhood (C/C), index reaction at childhood and test at adulthood (C/A), index reactions at childhood and adulthood and test at adulthood (CA/A), index reaction and test at adulthood (A/A).
A total of 3275 patients (67.9% female), comprising a total of 4370 patient-episodes, were evaluated (74.5% belonged to the A/A group). Prevalence of positive tests was 15.2% (95%CI, 14.1-16.2) for all tested classes, 10.6% (8.3-13.0) for C/C, 10.6% (7.5-13.6) for C/A, 22.1% (12.8-31.3) for CA/A and 16.5% (15.2-17.8) for A/A. The prevalence was lower in group C/C compared with groups A/A (P < 0.0001) and CA/A (P = 0.003). It was also lower in group C/A compared with the two latter groups (respectively P = 0.003 and P = 0.005). Significant differences were found for maculopapular exanthemas only, and not for urticaria/angiœdema and anaphylaxis. The difference was mainly observed with β-lactams and not for NSAIDs.
Suspicions of DHRs are less likely to be confirmed in children.
与成人相比，已证实的免疫球蛋白 E 或 T 细胞介导的药物超敏反应（DHR）在儿童中似乎较少见。然而，这从未被数据证明过。
确定并比较儿童和成人中已证实的 DHR 患病率。
使用 DAHD（药物过敏和超敏反应数据库）队列，将患有已证实的 DHR 的儿童与成人进行比较。遵循国际 EAACI-ENDA 建议。患者分为四组：儿童期的索引反应和测试（C/C）、儿童期的索引反应和成年期的测试（C/A）、儿童期和成年期的索引反应和成年期的测试（CA/A）、索引反应和成年期的测试（A/A）。
共评估了 3275 名患者（67.9%为女性），共 4370 名患者（74.5%属于 A/A 组）。所有测试类别的阳性测试率为 15.2%（95%CI，14.1-16.2），C/C 为 10.6%（8.3-13.0），C/A 为 10.6%（7.5-13.6），CA/A 为 22.1%（12.8-31.3），A/A 为 16.5%（15.2-17.8）。与 A/A 组和 CA/A 组相比，C/C 组的患病率较低（P<0.0001）和 CA/A 组（P=0.003）。与后两组相比，C/A 组的患病率也较低（分别为 P=0.003 和 P=0.005）。仅发现斑丘疹性皮疹有显著差异，而荨麻疹/血管性水肿和过敏反应无差异。差异主要与β-内酰胺类药物有关，而与非甾体抗炎药无关。
儿童中 DHR 的怀疑不太可能得到证实。
