Przybilla, Bernhard; Aberer, Werner; Bircher, Andreas J.; Brehler, Randolph; Brockow, Knut; Dickel, Heinrich; Fuchs, Thomas; Hertl, Michael; Mockenhaupt, Maja; Pfaar, Oliver; Ring, Johannes; Sachs, Bernhardt; Vieluf, Dieter; Wedi, Bettina; Worm, Margitta; Zuberbier, Torsten; Merk, Hans F.
Allergologische Diagnostik von Überempfindlichkeitsreaktionen auf Arzneimittel.
In: Laboratoriumsmedizin - Journal of Laboratory Medicine, Vol. 32, No. 6: pp. 450-455
Drug hypersensitivity reactions have to be tested to identify the culprit substance. The history includes the general information and specific data concerning used drugs, the classification and circumstances of the reaction. Skin tests are performed in all hypersensitivity reactions with allergic symptoms. Tests should be done between four weeks and six months after clearance of the symptoms by performing skin prick test, intradermal test, patch test or photopatch test. Validated tests for the detection of specific IgE antibodies in the serum are available for only few drugs, especially betalactam antibiotics. Other laboratory tests, e.g., the basophil activation test are done only in special cases. Provocation tests are indicated, if the culprit drug cannot be identified by the above mentioned tests. If possible, the evaluation of provocation tests should rely on objective parameters. The concluding assessment will be discussed with the patient and will be documented in an allergy pass.