Ariza Adriana, Mayorga Cristobalina, Bogas Gador, Barrionuevo Esther, Torres Maria J, Doña Inmaculada, Fernandez Tahia D
Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA-ARADyAL, Málaga, Spain.
Allergy Unit, Hospital Regional Universitario de Málaga-ARADyAL, Málaga, Spain.
Allergy. 2020 Dec;75(12):3112-3123. doi: 10.1111/all.14603. Epub 2020 Oct 9.
A correct diagnosis of drug hypersensitivity reactions (DHRs) is very important for both the patient and health system. However, DHRs diagnosis is complex, time consuming, requires trained personnel, is not standardized for many drugs, involves procedures not exempt of risk, and in most cases lacks standardized in vivo and in vitro tests. Thus, there is an urgent need for improving the different approaches to diagnose patients with suspected DHRs. In this review, we have analyzed the advances performed in immediate and nonimmediate DHRs diagnosis during the last two years and obtained several conclusions: the significant heterogeneity in current practice among centers illustrates the need to re-evaluate, update, and standardize in vivo tests and protocols for the diagnosis and management of patients with suspected drug allergy. Regarding in vitro tests, the latest studies have focused on increasing their sensitivity or on establishing the sensitivity and specificity for the tests performed with new drugs. There seems to be a consensus about combining in vivo and in vitro tests as the best way to increase the diagnostic accuracy.
正确诊断药物过敏反应（DHRs）对患者和卫生系统都非常重要。然而，DHRs的诊断很复杂，耗时较长，需要专业人员，许多药物的诊断方法并不标准，涉及有风险的程序，而且在大多数情况下缺乏标准化的体内和体外试验。因此，迫切需要改进诊断疑似DHRs患者的不同方法。在本综述中，我们分析了过去两年中在速发型和非速发型DHRs诊断方面取得的进展，并得出了几个结论：目前各中心在实践中的显著异质性表明，需要重新评估、更新和标准化用于诊断和管理疑似药物过敏患者的体内试验及方案。关于体外试验，最新研究集中在提高其敏感性或确定新药体外试验的敏感性和特异性。将体内试验和体外试验相结合似乎是提高诊断准确性的最佳方法，这一点已达成共识。
