Tools for Etiologic Diagnosis of Drug-Induced Allergic Conditions

Int J Mol Sci. 2023 Aug 8;24(16):12577. doi: 10.3390/ijms241612577.

Abstract

Drug hypersensitivity reactions are a serious concern in clinical practice because they can be severe and result in lifelong sequelae. An accurate diagnosis and identification of the culprit drug is essential to prevent future reactions as well as for the identification of safe treatment alternatives. Nonetheless, the diagnosis can be challenging. In vivo and in vitro tests can be helpful, although none are conclusive; therefore, the tests are not usually performed in isolation but as part of a diagnostic algorithm. In addition, some in vitro tests are only available in research laboratories, and standardization has not been fully accomplished. Collaborating research is needed to improve drug hypersensitivity reaction diagnosis. In this review, we update the current available in vivo and in vitro tools with their pros and cons and propose an algorithm to integrate them into clinical practice.

Keywords: IgE; T cells; anaphylaxis; diagnostic; drug hypersensitivity; in vitro tests; severe cutaneous reactions.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Causality
  • Disease Progression
  • Drug Hypersensitivity* / diagnosis
  • Drug Hypersensitivity* / etiology
  • Humans
  • Hypersensitivity* / diagnosis
  • Hypersensitivity* / etiology

Grants and funding

This study was partially funded by a grant from the Instituto de Salud Carlos III (Ministerio de Economía y Competitividad) FIS PI18/00718 (co-founded by FEDER) to T.B., FIS PI22/00221 (co-founded by FEDER) to R.R.-P., and a grant from SEAIC Sociedad española de Alergologia e Inmunologia Clinica to L.d.l.V.