Southern California Permanente Medical Group, Department of Allergy, San Diego Medical Center, San Diego, California, USA.
Ann Allergy Asthma Immunol. 2012 Feb;108(2):88-93. doi: 10.1016/j.anai.2011.11.006. Epub 2011 Dec 9.
Population-based data on the demographics and clinical characteristics of patients with multiple unrelated drug class intolerances noted in their medical records are lacking.
To provide population-based drug "allergy" incidence rates and prevalence, and to identify individuals with multiple drug intolerance syndrome (MDIS) defined by 3 or more unrelated drug class "allergies," and to provide demographic and clinical information on MDIS cases.
Electronic medical record data from 2,375,424 Kaiser Permanente Southern California health plan members who had a health care visit and at least 11 months of health care coverage during 2009 were reviewed. Population-based drug "allergy" incidence rates and prevalence were determined for 23 unrelated medication classes.
On January 1, 2009, 478,283 (20.1%) health plan members had at least one reported "allergy." Individuals with a history of at least 1 "allergy" and females, in general, reported higher population-based new "allergy" incidence rates. Multiple drug intolerance syndrome was present in 49,582 (2.1%). The MDIS cases were significantly older, 62.4 ± 16.1 years; heavier, body mass index 29.3 ± 7.1; and likely to be female, 84.9%, compared with average health plan members. They had high rates of health care utilization, medication usage, and new drug "allergy" incidence. They sought medical attention for common nonmorbid conditions.
Multiple drug intolerance syndrome is in part iatrogenic. It is associated with overweight elderly women who have high rates of health care and medication usage. Urticarial syndromes only explain a small fraction of MDIS cases. Multiple drug intolerance syndrome is associated with anxiety, but not predominately with immunoglobulin E (IgE)-mediated allergy or life-threatening illness. Multiple drug intolerance syndrome can be managed by medication avoidance and judicious rechallenge.
缺乏基于人群的记录中记录的多种非相关药物类别不耐受患者的人口统计学和临床特征数据。
提供基于人群的药物“过敏”发生率和患病率，并确定由 3 种或更多种非相关药物类别“过敏”定义的多种药物不耐受综合征（MDIS）个体，并提供 MDIS 病例的人口统计学和临床信息。
审查了 2009 年期间在 Kaiser Permanente Southern California 医疗保健计划中有医疗就诊且至少有 11 个月医疗保健覆盖的 2,375,424 名成员的电子病历数据。确定了 23 种无关药物类别的基于人群的药物“过敏”发生率和患病率。
2009 年 1 月 1 日，有 478,283（20.1%）名健康计划成员至少报告了一次“过敏”。有至少一次“过敏”病史的个体和一般女性报告的人群中新“过敏”发生率更高。存在多种药物不耐受综合征的有 49,582（2.1%）例。MDIS 病例明显更年长，62.4±16.1 岁；更重，体重指数 29.3±7.1；更可能是女性，84.9%，与平均健康计划成员相比。他们的医疗保健利用率、药物使用和新药物“过敏”发生率很高。他们因常见的非病态疾病寻求医疗。
多种药物不耐受综合征部分是医源性的。它与超重的老年女性有关，这些女性的医疗保健和药物使用率很高。荨麻疹综合征仅解释了一小部分 MDIS 病例。多种药物不耐受综合征与焦虑有关，但不是主要与免疫球蛋白 E（IgE）介导的过敏或危及生命的疾病有关。多种药物不耐受综合征可以通过避免药物和明智的再挑战来治疗。
