ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
|
|
|
Tests Used For The Diagnosis Of Drug Allergies: Review
Dr. Nihal METE GÖKMEN, a Dr. Ramazan ERSOYa
a İç Hastalıkları ABD, İmmünoloji ve Allerji BD, Ege Üniversitesi Tıp Fakültesi, İZMİR
The diagnosis of a drug allergy is mainly based on a very detailed history and physical examination. In addition, several in vitro or in vivo tests can be performed to demonstrate sensitization to a certain drug. In vivo tests are skin tests and provocation tests.
While prick tests and intradermal tests are used for the diagnosis of IgE-mediated allergic reactions, patch and photopatch tests are preferred for the diagnosis of delayed type reactions. If immediate type allergic reactions such as urticaria, angioedema, rhinitis, conjunctivitis, bronchospasm, or hypotension occur soon after drug use, the prick test and the intradermal test should be performed.
The gold standard for the diagnosis of drug allergy is the combination of relevant history and challenge test with the suspected drug.
In vitro tests, used for the diagnosis of patients with drug allergy, are drug-specific IgE, the lymphocyte transformation test and allergen induced mediator release tests. Specific IgE has a lower sensitivity and a higher specificity than skin tests. However, it is much more expensive than skin tests.
The lymphocyte transformation test (LTT) is used to determine drug sensitivity mediated by T cells.
Allergen-induced mediator release assays analyze the mediator, which are released from effector cells, most probably basophiles, when stimulated in vitro with serial dilutions of the putative allergens.
Release of Cys-LT produced in vitro by isolated peripheral blood leukocytes after drug allergen stimulation, is measured by the cellular antigen stimulation test (CAST) technique.
Flow cytometric basophile activation test (BAT) detects the enhancement of the percent expression of surface CD63 and CD203c markers. This technique is increasingly used in the in vitro diagnosis of drug allergy.
In this review, in vitro and in vivo tests used to detect drug sensitization are discussed.Keywords: Drug hypersensitivity; skin tests; flow cytometry; nasal provocation testsTurkiye Klinikleri J Med Sci 2008, 28:48-57
|
|
|
|
|
