Clinical characteristics and risk factors for escalation to anaphylaxis from non‐severe drug hypersensitivity reaction
Abstract Background Drug hypersensitivity reaction (DHR) poses significant challenges in clinical practice, with some patients experiencing more severe reactions upon re‐exposure. Understanding the factors contributing to escalation into more severe reactions is crucial for improving patient safety....
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| Format: | Article |
| Language: | English |
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Wiley
2025-04-01
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| Series: | Clinical and Translational Allergy |
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| Online Access: | https://doi.org/10.1002/clt2.70047 |
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| author | Hyo‐In Rhyou Sung‐Ryeol Kim Jae‐Woo Jung Sae‐Hoon Kim Ji‐Hyang Lee Hye Jung Park Kyung‐Hee Park Hee‐Sun Park Eun‐Hee Chung Gil‐Soon Choi Sujeong Kim Min‐Suk Yang Jung‐Yeon Shim Young‐Il Koh Da‐Woon Sim Jae‐Hyun Lee Young‐Hee Nam Hye‐Ryun Kang |
| author_facet | Hyo‐In Rhyou Sung‐Ryeol Kim Jae‐Woo Jung Sae‐Hoon Kim Ji‐Hyang Lee Hye Jung Park Kyung‐Hee Park Hee‐Sun Park Eun‐Hee Chung Gil‐Soon Choi Sujeong Kim Min‐Suk Yang Jung‐Yeon Shim Young‐Il Koh Da‐Woon Sim Jae‐Hyun Lee Young‐Hee Nam Hye‐Ryun Kang |
| author_sort | Hyo‐In Rhyou |
| collection | DOAJ |
| description | Abstract Background Drug hypersensitivity reaction (DHR) poses significant challenges in clinical practice, with some patients experiencing more severe reactions upon re‐exposure. Understanding the factors contributing to escalation into more severe reactions is crucial for improving patient safety. This study aimed to investigate the clinical characteristics and risk factors associated with the progression from non‐severe DHR to anaphylaxis. Methods A multicenter retrospective study was conducted using data from a drug‐induced anaphylaxis registry across 10 university hospitals in Korea. Clinical data, including information on culprit drugs, DHR history, and the severity of reactions, were assessed. Results Among 494 cases of drug‐induced anaphylaxis, 417 cases (84.4%) occurred without prior DHR, while 77 cases (15.6%) had a history of non‐severe DHR. Of these, 43 cases had a previous DHR to a drug of the same class, and 34 cases involved DHR to drugs of different classes. In the group with prior DHR to a drug of the same class, anaphylaxis occurring in daily life was significantly more common compared to those reacting to a different class of drug or those with no prior DHR (48.8% vs. 23.5% or 22.5%, p = 0.008 and < 0.001, respectively). Non‐steroidal anti‐inflammatory drugs (NSAIDs), H2 blockers, and penicillins were identified as risk factors for anaphylaxis evolving from non‐severe DHR. Conclusion Enhanced vigilance is required for patients with a history of non‐severe DHR to NSAIDs, H2 blockers, and penicillins as re‐exposure may lead to the progress to anaphylaxis. |
| format | Article |
| id | doaj-art-82d020a7e7fc49c69e4b7a179a22c229 |
| institution | DOAJ |
| issn | 2045-7022 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Translational Allergy |
| spelling | doaj-art-82d020a7e7fc49c69e4b7a179a22c2292025-08-20T03:15:03ZengWileyClinical and Translational Allergy2045-70222025-04-01154n/an/a10.1002/clt2.70047Clinical characteristics and risk factors for escalation to anaphylaxis from non‐severe drug hypersensitivity reactionHyo‐In Rhyou0Sung‐Ryeol Kim1Jae‐Woo Jung2Sae‐Hoon Kim3Ji‐Hyang Lee4Hye Jung Park5Kyung‐Hee Park6Hee‐Sun Park7Eun‐Hee Chung8Gil‐Soon Choi9Sujeong Kim10Min‐Suk Yang11Jung‐Yeon Shim12Young‐Il Koh13Da‐Woon Sim14Jae‐Hyun Lee15Young‐Hee Nam16Hye‐Ryun Kang17Department of Internal Medicine Inje University Haeundae Paik Hospital Inje University College of Medicine Busan KoreaDepartment of Internal Medicine Yongin Severance Hospital Yonsei University College of Medicine Yongin KoreaDepartment of Internal Medicine Chung‐Ang University Hospital Seoul KoreaDepartment of Internal Medicine Seoul National University Bundang Hospital Seongnam KoreaDrug Safety Center Seoul National University Hospital Seoul KoreaDepartment of Internal Medicine Gangnam Severance Hospital Yonsei University College of Medicine Seoul KoreaDepartment of Internal Medicine Institute of Allergy Yonsei University College of Medicine Severance Hospital Seoul KoreaDepartment of Internal Medicine Chungnam National University Hospital Daejeon KoreaDepartment of Pediatrics Chungnam National University Hospital Chungnam National University School of Medicine Daejeon KoreaDepartment of Internal Medicine Kosin University College of Medicine Busan KoreaDepartment of Internal Medicine School of Medicine Kyungpook National University Daegu KoreaDepartment of Internal Medicine Seoul Metropolitan Government‐Seoul National University Boramae Medical Center Seoul KoreaDepartment of Pediatrics Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul KoreaDivision of Allergy and Clinical Immunology Department of Internal Medicine Chonnam National University Hospital Chonnam National University Medical School Gwangju KoreaDivision of Allergy and Clinical Immunology Department of Internal Medicine Chonnam National University Hospital Chonnam National University Medical School Gwangju KoreaDepartment of Internal Medicine Institute of Allergy Yonsei University College of Medicine Severance Hospital Seoul KoreaDepartment of Internal Medicine Dong‐A University College of Medicine Busan KoreaDepartment of Internal Medicine Seoul National University College of Medicine Seoul KoreaAbstract Background Drug hypersensitivity reaction (DHR) poses significant challenges in clinical practice, with some patients experiencing more severe reactions upon re‐exposure. Understanding the factors contributing to escalation into more severe reactions is crucial for improving patient safety. This study aimed to investigate the clinical characteristics and risk factors associated with the progression from non‐severe DHR to anaphylaxis. Methods A multicenter retrospective study was conducted using data from a drug‐induced anaphylaxis registry across 10 university hospitals in Korea. Clinical data, including information on culprit drugs, DHR history, and the severity of reactions, were assessed. Results Among 494 cases of drug‐induced anaphylaxis, 417 cases (84.4%) occurred without prior DHR, while 77 cases (15.6%) had a history of non‐severe DHR. Of these, 43 cases had a previous DHR to a drug of the same class, and 34 cases involved DHR to drugs of different classes. In the group with prior DHR to a drug of the same class, anaphylaxis occurring in daily life was significantly more common compared to those reacting to a different class of drug or those with no prior DHR (48.8% vs. 23.5% or 22.5%, p = 0.008 and < 0.001, respectively). Non‐steroidal anti‐inflammatory drugs (NSAIDs), H2 blockers, and penicillins were identified as risk factors for anaphylaxis evolving from non‐severe DHR. Conclusion Enhanced vigilance is required for patients with a history of non‐severe DHR to NSAIDs, H2 blockers, and penicillins as re‐exposure may lead to the progress to anaphylaxis.https://doi.org/10.1002/clt2.70047anaphylaxisdrug hypersensitivityH2 receptor antagonistsnon‐steroidal anti‐inflammatory agentspenicillins |
| spellingShingle | Hyo‐In Rhyou Sung‐Ryeol Kim Jae‐Woo Jung Sae‐Hoon Kim Ji‐Hyang Lee Hye Jung Park Kyung‐Hee Park Hee‐Sun Park Eun‐Hee Chung Gil‐Soon Choi Sujeong Kim Min‐Suk Yang Jung‐Yeon Shim Young‐Il Koh Da‐Woon Sim Jae‐Hyun Lee Young‐Hee Nam Hye‐Ryun Kang Clinical characteristics and risk factors for escalation to anaphylaxis from non‐severe drug hypersensitivity reaction Clinical and Translational Allergy anaphylaxis drug hypersensitivity H2 receptor antagonists non‐steroidal anti‐inflammatory agents penicillins |
| title | Clinical characteristics and risk factors for escalation to anaphylaxis from non‐severe drug hypersensitivity reaction |
| title_full | Clinical characteristics and risk factors for escalation to anaphylaxis from non‐severe drug hypersensitivity reaction |
| title_fullStr | Clinical characteristics and risk factors for escalation to anaphylaxis from non‐severe drug hypersensitivity reaction |
| title_full_unstemmed | Clinical characteristics and risk factors for escalation to anaphylaxis from non‐severe drug hypersensitivity reaction |
| title_short | Clinical characteristics and risk factors for escalation to anaphylaxis from non‐severe drug hypersensitivity reaction |
| title_sort | clinical characteristics and risk factors for escalation to anaphylaxis from non severe drug hypersensitivity reaction |
| topic | anaphylaxis drug hypersensitivity H2 receptor antagonists non‐steroidal anti‐inflammatory agents penicillins |
| url | https://doi.org/10.1002/clt2.70047 |
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