Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal.
Unidade de Imunoalergologia, Hospital Lusíadas Porto, Porto, Portugal.
Pediatr Allergy Immunol. 2023 Jun;34(6):e13965. doi: 10.1111/pai.13965.
Any drug can potentially induce a hypersensitivity reaction. If after the allergological work-up the drug hypersensitivity reaction is confirmed, in most cases, the simple avoidance of the culprit drug and a suggestion of an unrelated alternative is enough. However, there are circumstances where the choice to stop the treatment affects the survival, the safety and/or the quality of life of the patient and the global outcome of the disease in question. When this occurs, drug desensitization can be the answer and should not be viewed as an extravagance, nor the pediatric age should be considered a contraindication. Drug desensitization in children can be safely and successfully performed, having a positive impact on the survival and overall prognosis. In general, the indications for DDS are the same in adults as in children. However, in this age group there are specificities that this paper aimed to describe, reviewing the mechanisms behind drug hypersensitivity and rapid drug desensitization, types of protocols, indications, and contraindications, as well as several technical aspects that are specific to the pediatric age.
任何药物都有可能引发过敏反应。如果在过敏检查后确认了药物过敏反应,在大多数情况下,简单地避免使用致敏药物并建议使用不相关的替代药物就足够了。然而,在某些情况下,停止治疗的选择会影响患者的生存、安全和/或生活质量以及所讨论疾病的整体结果。当这种情况发生时,药物脱敏可能是答案,不应被视为奢侈,也不应将儿科年龄视为禁忌症。儿童的药物脱敏可以安全有效地进行,对生存和整体预后有积极影响。一般来说,DDS 的适应证在成人和儿童中是相同的。然而,在这个年龄组中,有一些特殊性,本文旨在描述,回顾药物过敏和快速脱敏的机制,各种方案的类型、适应证和禁忌证,以及儿科特有的几个技术方面。