Keywords
Hipersensibilidad a fármacos
Toma de decisiones
Pruebas cutáneas
Pruebas intradérmicas
Abstract
Background
Diagnosis of drug hypersensitivity bases on detailed clinical history and skin and challenge tests, which may involve an unaffordable risk. Knowing the reproducibility of reactions could help on the decision of performing them according to safety criteria.
Objective
The aim was to assess the reproducibility of symptoms in drug challenge tests.
Methods
The study included patients with positive cutaneous or challenge test throughout 2019. For each patient, clinical suspicion according to Karch-Lasagna algorithm was registered. Primary outcome was the reproducibility of symptoms in the provocation tests using a paired analysis of data with McNemar test.
Results
Eighty nine patients were included, 16 of them presented more than one positive test. Thirty were skin tests positive and 75 reacted to provocation tests. Eighty nine percent of patients who reacted in challenge test were probably or possibly reactors according to Karch-Lasagna scale. Symptoms of initial reaction did not differ from those triggered in challenge tests.
Conclusions
Karch-Lasagna scale is useful in predicting the response to drug provocation tests. In most of the positive studies, results were suggested by clinical history and no differences were found between symptoms triggered in challenge test and that referred to in the previous reaction.
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