A drug provocation test (DPT) is the controlled administration of a drug in order to diagnose drug hypersensitivity reactions. DPTs are performed under medical surveillance, whether this drug is an alternative compound, or structurally/pharmacologically related, or the suspected drug itself. DPT is sometimes termed controlled challenge or reexposure (1), drug challenge (2), graded (2) or increm...

BACKGROUND Drug hypersensitivity is classically divided into IgE mediated and non-IgE mediated disease. We report a rare case of consequent IgE mediated and non-IgE mediated reactions within the beta lactam class of antibiotics. CASE SUMMARY An 84-year-old man developed toxic epidermal necrolysis (TEN) due to ceftriaxone, a third generation cephalosporin, involving 72% of the body surface are...

Currently no therapy of acute lymphoblastic leukemia is conceivable without L-asparaginase drugs, with its antileukemic effect by extracellular asparagine depletion, thus preventing admission to leukemic cell. Besides high antitumor effect, drugs have side and toxic effects, such as hypersensitivity reactions, thrombosis, pancreatitis / pancreatic necrosis, hepatotoxicity. For safety profile im...

Phase I and II enzymes are involved in the metabolism of endogenous reactive compounds as well as xenobiotics, including toxicants and drugs. Genotyping studies have established several drug metabolizing enzymes as markers for risk of drug hypersensitivity. However, other candidates are emerging that are involved in drug metabolism but also in the generation of danger or costimulatory signals. ...

Small chemicals like drugs tend to bind to proteins via noncovalent bonds, e.g. hydrogen bonds, salt bridges or electrostatic interactions. Some chemicals interact with other molecules than the actual target ligand, representing so-called 'off-target' activities of drugs. Such interactions are a main cause of adverse side effects to drugs and are normally classified as predictable type A reacti...

In vivo tests may be used for the diagnosis of allergy to iodinated contrast media (ICM); however, the tests do not provide definitive diagnosis and are associated with risks for patients. Diagnoses based on in vitro tests are limited, and there are almost no relevant studies. Herein, the authors examined involvement of allergic reaction from a multilateral standpoint in 39 patients suspected o...

Small molecules, used as drugs, can induce immune reactions by binding covalently as haptens to a carrier protein, which is thereby modified and immunogenic. In addition, drugs bind to proteins via hydrogen bonds, electrostatic force, and van der Waals forces, and may directly interact with immune receptors such as T cell receptors or major histocompatibility complex molecules (pharmacologic in...

Balsalazide is used in short term and maintenance treatment of ulcerative colitis. It is a prodrug in which 5-aminosalicylic acid is linked via a diazo bond to 4-aminobenzoyl-â-alanine, an inert and biologically inactive carrier molecule. We report a case of a hypersensitivity reaction to balsalazide, involving pericarditis, an abnormal liver biochemistry profile, and splinter haemorrhages. A 5...

Background Stevens-Johnson syndrome (SJS) / toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) / drug-induced hypersensitivity syndrome (DIHS) are recognized as severe cutaneous adverse reactions (SCARs) usually induced by drugs. Due to the high risk of mortality, management of patients with SCARs requires rapid diagnosis. However, it is difficul...