Allergy Unit, Hôpital Arnaud de Villeneuve, Montpellier, France.
Curr Opin Allergy Clin Immunol. 2013 Aug;13(4):323-9. doi: 10.1097/ACI.0b013e3283630c36.
The multiple drug hypersensitivity syndrome (MDH) is a distinct clinical entity, different from cross-reactivity and flare-up reactions. Following its initial description in 1989 by Sullivan et al., several authors have addressed the issues surrounding this peculiar form of drug hypersensitivity. Whether this syndrome is single or can be further classified in several entities is still a matter of debate.
Case reports, case series or studies involving large populations on MDH are few. The use of this term in the literature is heterogeneous, and the definitions variable. Given the major advances in the study of drug hypersensitivities in general, and ongoing research regarding severe cutaneous adverse reactions in particular, careful study of the subgroup of patients with demonstrated immunological basis of MDH has enabled the generation of possible pathogenetic hypotheses. Together with the studies (despite their limitations) to estimate the prevalence of this syndrome in adult and paediatric patients these emerging data need confirmation through larger studies with well defined populations.
Bringing together the experience of groups involved in the field of drug allergy should help to move knowledge regarding this peculiar form of drug hypersensitivity forward.
多重药物过敏综合征(MDH)是一种独特的临床实体,与交叉反应和加剧反应不同。自 Sullivan 等人于 1989 年首次描述以来,已有多位作者探讨了这种特殊形式药物过敏的相关问题。该综合征是单一的,还是可以进一步分为几种实体,目前仍存在争议。
关于 MDH 的病例报告、病例系列或涉及大量人群的研究很少。文献中对该术语的使用存在异质性,定义也各不相同。鉴于一般药物过敏研究的重大进展,特别是严重皮肤不良反应的研究不断深入,对具有 MDH 免疫基础的患者亚组进行仔细研究,有助于提出可能的发病假说。此外,尽管这些研究(存在局限性)估计了成人和儿科患者中该综合征的患病率,但需要通过具有明确人群的更大规模研究来证实这些新兴数据。
汇集参与药物过敏领域的各个团体的经验,应该有助于推动对这种特殊形式药物过敏的认识。