Tools to improve the diagnosis and management of T-cell mediated adverse drug reactions
- Author(s)
- Copaescu, AM; Ben-Shoshan, M; Trubiano, JA;
- Journal Title
- Frontiers in Medicine
- Publication Type
- Review
- Abstract
- Delayed drug T-cell immune-mediated hypersensitivity reactions have a large clinical heterogeneity varying from mild maculopapular exanthema (MPE) to severe cutaneous adverse reactions (SCARs) such as acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS) and severe skin necrosis and blistering as seen in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Given the knowledge gaps related to the immunopathogenesis of these conditions, the absence of validated diagnostic tools and the significant associated morbidity and mortality, patients with SCARs often have limited drug choices. We performed a comprehensive review aiming to evaluate in vivo diagnostic tools such as delayed intradermal skin and patch testing and ex vivo/in vitro research assays such as the lymphocyte transformation test (LTT) and the enzyme-linked ImmunoSpot (ELISpot) assay. We searched through PubMed using the terms "drug allergy," "in vivo" and "ex vivo" for original papers in the last 10 years. A detailed meticulous approach adapted to the various clinical phenotypes is recommended for the diagnostic and management of delayed drug hypersensitivity reactions. This review highlights the current diagnostic tools for the delayed drug hypersensitivity phenotypes.
- Keywords
- Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN); delayed hypersensitivity reaction; diagnostic tools; drug allergy; drug reaction with eosinophilia and systemic symptoms (DRESS); ex vivo; in vivo; severe cutaneous adverse reactions (SCARs)
- Department(s)
- Infectious Diseases
- PubMed ID
- 36313986
- Publisher's Version
- https://doi.org/10.3389/fmed.2022.923991
- Open Access at Publisher's Site
https://doi.org/10.3389/fmed.2022.923991- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-10-18 05:06:10
Last Modified: 2024-10-18 05:07:17