[Reproducibilidad clínica de reacciones de hipersensibilidad a fármacos en pruebas de exposición controlada].

A Alberto Palacios Cañas, Jaime Vinicio Meneses Sotomayor, Míriam Clar Castelló, Elisa Gómez Torrijos, Jesus María Borja Segade, Rosa García Rodríguez
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Abstract

Objective: To assess the reproducibility of symptoms in drug challenge tests.

Methods: The study included patients with positive cutaneous or challenge test throughout 2019. For each patient, clinical suspicion according to Karch-Lasagna algorithm was registered. Primary outcome was the reproducibility of symptoms in the provocation tests using a paired analysis of data with McNemar test.

Results: Eighty-nine patients were included, 16 of them presented more than one positive test. Thirty were skin tests positive and 75 reacted to provocation tests. Eighty nine percent of patients who reacted in challenge test were probably or possibly reactors according to Karch-Lasagna scale. Symptoms of initial reaction did not differ from those triggered in challenge tests.

Conclusions: Karch-Lasagna scale is useful in predicting the response to drug provocation tests. In most of the positive studies, results were suggested by clinical history and no differences were found between symptoms triggered in challenge test and that referred to in the previous reaction.

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[控制暴露试验中药物过敏反应的临床再现性]。
目的:评估药物激发试验中症状的再现性。方法:该研究纳入了2019年全年皮肤或激发试验呈阳性的患者。对于每一位患者,根据Karch Lasagna算法进行临床怀疑登记。主要结果是使用McNemar试验对数据进行配对分析的激发试验中症状的再现性。结果:89名患者被包括在内,其中16人的检测结果呈阳性。30人的皮肤测试呈阳性,75人对刺激测试有反应。根据Karch Lasagna量表,在激发试验中有反应的患者中,89%可能是或可能是反应者。最初反应的症状与激发试验中引发的症状没有区别。结论:卡氏Lasagna量表可用于预测药物激发试验的反应。在大多数阳性研究中,结果是由临床病史提示的,在激发试验中引发的症状和先前反应中提到的症状之间没有发现差异。
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