Diagnostic procedures & practices in drug allergy/hypersensitivity: a survey of 13 Asian countries
Min-Moon Tang
(1)
,
Jie Shen Fok
(2, 3)
,
Bernard Yu-Hor Thong
(4)
,
James Yun
(5, 6)
,
Philip Hei Li
(7, 8)
,
Hye-Ryun Kang
(9, 10)
,
Francis Thien
(3)
,
Masao Yamaguchi
(11)
,
Michaela Lucas
(12, 13)
,
Yoon-Seok Chang
(14)
,
Byung-Keun Kim
(15)
,
Mizuho Nagao
(16)
,
Iris Rengganis
(17, 18)
,
Yi-Giien Tsai
(19)
,
Wen-Hung Chung
(20, 21)
,
Ticha Rerkpattanapipat
(22, 23)
,
Wasu Kamchaisatian
(24)
,
Ting Fan Leung
(25)
,
Joo-Yoon Ho
(26)
,
Luo Zhang
(27, 28)
,
Amir Hamzah Abdul Latiff
(29)
,
Takao Fujisawa
(16)
,
Mariana Castells
(30)
,
Pascal Demoly
(31, 32, 33)
,
Jiu Yao Wang
(34)
,
Ruby Pawankar
(35)
1
Hospital Kuala Lumpur
2 Box Hill Hospital
3 Monash University [Melbourne]
4 Tan Tock Seng Hospital
5 The University of Sydney
6 Nepean Hospital
7 Queen Mary Hospital
8 HKU - The University of Hong Kong
9 SNU - Seoul National University [Seoul]
10 Seoul National University Hospital
11 Teikyo University School of Medicine
12 Sir Charles Gairdner Hospital
13 UWA - The University of Western Australia
14 SNUBH - Seoul National University Bundang Hospital
15 Korea University Anam Hospital [Seoul]
16 Mie National Hospital [Tsu]
17 UI - Universitas Indonesia
18 Cipto Mangunkusumo Hospital [Jakarta]
19 Kaohsiung Medical University
20 CGMH - Chang Gung Memorial Hospital [Taipei]
21 Chang Gung University [Taïwan]
22 Ramathibodi Hospital [Bangkok, Thailand]
23 Mahidol University [Bangkok]
24 Samitivej Children's Hospital [Bangkok]
25 CUHK - The Chinese University of Hong Kong [Hong Kong]
26 Hanyang University
27 Beijing Tongren Hospital
28 CUMS - Capital University of Medical Sciences [Beijing]
29 Pantai Hospital [Kuala Lumpur]
30 BWH - Brigham & Women’s Hospital [Boston]
31 Département pneumologie et addictologie [Montpellier]
32 EPAR - Epidemiology of Allergic and Respiratory Diseases Department [iPlesp]
33 UM - Université de Montpellier
34 NCKU - National Cheng Kung University
35 Nippon Medical School [Tokyo, Japon]
2 Box Hill Hospital
3 Monash University [Melbourne]
4 Tan Tock Seng Hospital
5 The University of Sydney
6 Nepean Hospital
7 Queen Mary Hospital
8 HKU - The University of Hong Kong
9 SNU - Seoul National University [Seoul]
10 Seoul National University Hospital
11 Teikyo University School of Medicine
12 Sir Charles Gairdner Hospital
13 UWA - The University of Western Australia
14 SNUBH - Seoul National University Bundang Hospital
15 Korea University Anam Hospital [Seoul]
16 Mie National Hospital [Tsu]
17 UI - Universitas Indonesia
18 Cipto Mangunkusumo Hospital [Jakarta]
19 Kaohsiung Medical University
20 CGMH - Chang Gung Memorial Hospital [Taipei]
21 Chang Gung University [Taïwan]
22 Ramathibodi Hospital [Bangkok, Thailand]
23 Mahidol University [Bangkok]
24 Samitivej Children's Hospital [Bangkok]
25 CUHK - The Chinese University of Hong Kong [Hong Kong]
26 Hanyang University
27 Beijing Tongren Hospital
28 CUMS - Capital University of Medical Sciences [Beijing]
29 Pantai Hospital [Kuala Lumpur]
30 BWH - Brigham & Women’s Hospital [Boston]
31 Département pneumologie et addictologie [Montpellier]
32 EPAR - Epidemiology of Allergic and Respiratory Diseases Department [iPlesp]
33 UM - Université de Montpellier
34 NCKU - National Cheng Kung University
35 Nippon Medical School [Tokyo, Japon]
Jie Shen Fok
- Fonction : Auteur
- PersonId : 807205
- ORCID : 0000-0002-3450-0877
Bernard Yu-Hor Thong
- Fonction : Auteur
- PersonId : 791913
- ORCID : 0000-0002-6338-8482
James Yun
- Fonction : Auteur
- PersonId : 807206
- ORCID : 0000-0002-3482-5663
Philip Hei Li
- Fonction : Auteur
- PersonId : 807207
- ORCID : 0000-0002-9155-9162
Hye-Ryun Kang
- Fonction : Auteur
- PersonId : 807208
- ORCID : 0000-0002-2317-4201
Francis Thien
- Fonction : Auteur
- PersonId : 794313
- ORCID : 0000-0003-0925-6566
Masao Yamaguchi
- Fonction : Auteur
- PersonId : 807209
- ORCID : 0000-0001-6167-0591
Michaela Lucas
- Fonction : Auteur
- PersonId : 807210
- ORCID : 0000-0001-8881-9990
Yoon-Seok Chang
- Fonction : Auteur
- PersonId : 791914
- ORCID : 0000-0003-3157-0447
Byung-Keun Kim
- Fonction : Auteur
- PersonId : 807211
- ORCID : 0000-0001-5147-6306
Mizuho Nagao
- Fonction : Auteur
- PersonId : 807212
- ORCID : 0000-0003-3557-8761
Iris Rengganis
- Fonction : Auteur
- PersonId : 807213
- ORCID : 0000-0001-8748-8544
Yi-Giien Tsai
- Fonction : Auteur
- PersonId : 807214
- ORCID : 0000-0002-6744-1682
Wen-Hung Chung
- Fonction : Auteur
- PersonId : 795644
- ORCID : 0000-0003-1681-0959
Ticha Rerkpattanapipat
- Fonction : Auteur
- PersonId : 807215
- ORCID : 0000-0002-6630-2795
Wasu Kamchaisatian
- Fonction : Auteur
- PersonId : 807216
- ORCID : 0000-0003-0839-7682
Ting Fan Leung
- Fonction : Auteur
- PersonId : 807217
- ORCID : 0000-0002-6469-1926
Luo Zhang
- Fonction : Auteur
- PersonId : 783934
- ORCID : 0000-0002-0910-9884
Amir Hamzah Abdul Latiff
- Fonction : Auteur
- PersonId : 783501
- ORCID : 0000-0002-6304-0494
Takao Fujisawa
- Fonction : Auteur
- PersonId : 807218
- ORCID : 0000-0002-9196-9436
Mariana Castells
- Fonction : Auteur
- PersonId : 793711
- ORCID : 0000-0001-6451-0163
Pascal Demoly
- Fonction : Auteur
- PersonId : 754222
- IdHAL : pascal-demoly
- ORCID : 0000-0001-7827-7964
- IdRef : 03442959X
Ruby Pawankar
- Fonction : Auteur
- PersonId : 767956
- ORCID : 0000-0002-3091-7237
Résumé
Background: The issues and challenges in the diagnosis of drug allergy/hypersensitivity among children and adults in Asia are likely to be different from non-Asian countries.
Objective: To study the diagnostic modalities used in the evaluation and management of drug allergy/drug hypersensitivity reactions (DHRs) among member societies of the Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI).
Methods: A questionnaire comprising 41 questions was circulated electronically to member societies and individual members of APAAACI between January 23, 2020 and March 6, 2020.
Results: Twenty-six respondents from 15 member societies and 1 individual member responded. European DHR guidelines were most commonly used. Skin prick and intradermal testing was used by 100%, with only 60% having access to commercial penicillin skin test reagents. In vitro-specific IgE tests were used by 75%, and basophil activation test by 56.3% for immediate DHR. Patch tests were used by 75% in contrast to lymphocyte transformation tests by 25% for nonimmediate DHR. Drug provocation tests were used by 68.8%, the most common indication being to exclude hypersensitivity where history/symptoms were not suggestive of drug hypersensitivity/allergy (93.3%). Human leukocyte antigen (HLA) genotype testing was mandatory among 25% respondents before new carbamazepine prescriptions, and 8.3% for allopurinol prescriptions.
Conclusions: There was increased use of skin testing for iodinated contrast media hypersensitivity and patch testing for nonimmediate DHR. HLA genotype testing prior to new carbamazepine, allopurinol and abacavir prescriptions remain variable despite strong associations for severe cutaneous adverse reactions with Asian ethnicity. Results of this survey form a useful framework for developing educational and training needs and for improving access to drug allergy diagnostic and treatment modalities across APAAACI member societies.