Institute for Health Research Hospital Universitario La Paz (IdiPAZ), Paseo Castellana 261, 28046 Madrid, Spain.
Allergy Department, La Paz University Hospital, Paseo Castellana 261, 28046 Madrid, Spain.
Int J Mol Sci. 2023 Aug 8;24(16):12577. doi: 10.3390/ijms241612577.
Drug hypersensitivity reactions are a serious concern in clinical practice because they can be severe and result in lifelong sequelae. An accurate diagnosis and identification of the culprit drug is essential to prevent future reactions as well as for the identification of safe treatment alternatives. Nonetheless, the diagnosis can be challenging. In vivo and in vitro tests can be helpful, although none are conclusive; therefore, the tests are not usually performed in isolation but as part of a diagnostic algorithm. In addition, some in vitro tests are only available in research laboratories, and standardization has not been fully accomplished. Collaborating research is needed to improve drug hypersensitivity reaction diagnosis. In this review, we update the current available in vivo and in vitro tools with their pros and cons and propose an algorithm to integrate them into clinical practice.
药物过敏反应是临床实践中的一个严重问题,因为它们可能很严重,并导致终身后遗症。准确的诊断和鉴定罪魁祸首药物对于预防未来的反应以及识别安全的治疗替代方案至关重要。尽管如此,诊断可能具有挑战性。体内和体外测试可能会有所帮助,尽管没有一个是确定的;因此,这些测试通常不是单独进行的,而是作为诊断算法的一部分。此外,一些体外测试仅在研究实验室中可用,并且尚未完全实现标准化。需要开展合作研究来改善药物过敏反应的诊断。在这篇综述中,我们更新了当前可用的体内和体外工具及其优缺点,并提出了一个将它们整合到临床实践中的算法。