Page 65 - Proceeding of Plenary Abstract of Parallel Symposim

Drug Allergy in Children: Over and Under Diagnosis

Lily Irsa
Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara/Haji Adam Malik General Hospital , Medan, North Sumatera, Indonesia
Abstract
Background Drug hypersensitivity reactions (DHRs) are known as adverse effects of pharmaceutical
formulations (including active drugs and excipients) that clinically resemble allergy, and drug allergies are
DHRs for which a definite immunological mechanism is demonstrated. About 10% of the parent report
suspected hypersensitivity to at least one drug in their children. After a full allergy workup, only a few of
the suspected reactions can be confirmed as drug hypersensitivity reactions. Clinical presentations of DHR
are diverse, ranging from maculopapular and non- immediate urticarial exanthemas to life threatening
reaction, such as anaphylaxis and severe cutaneous adverse reaction (SCAR). Diagnostic approach to drug
hypersensitivity are consist of clinical history, skin test, laboratory test (if available and validated) and drug
provocation test. Discussion Overdiagnosis of DHR has known negative implications in clinical practice,
labels out patients, preventing the use of required “good” medications, and drives to alternative, less “good”,
or more toxic or more costly, medical decisions. On the other hand, under-recognition, underdiagnosis,
and under notification of these conditions are recognized key factors to the potential increased number of
avoidable recurrences, treatment/hospitalization, and risk of death. Factors are associated with an increased
risk of developing a drug allergy include patient-related factors (e.g., age, gender, genetic polymorphisms, or
infections with certain viruses) and drug-related factors (e.g., frequency of exposure, route of administration,
or molecular weight). Conclusion A carefully obtain of clinical history and specific allergy work up are
required to confirm diagnosis of HDR.

50 Abstract