scholarly journals Heart disease and the risk of allopurinol-associated severe cutaneous adverse reactions: a general population–based cohort study

2019 ◽  
Vol 191 (39) ◽  
pp. E1070-E1077 ◽  
Author(s):  
Chio Yokose ◽  
Na Lu ◽  
Hui Xie ◽  
Lingyi Li ◽  
Yufei Zheng ◽  
...  
Keyword(s):  
Cohort Study ◽  
Heart Disease ◽  
General Population ◽  
Adverse Reactions ◽  
Population Based ◽  
Severe Cutaneous Adverse Reactions ◽  
Cutaneous Adverse Reactions

scholarly journals RISK OF STROKE IN ADULT PATIENTS WITH CONGENITAL HEART DISEASE COMPARED WITH THE GENERAL POPULATION: A DANISH NATIONWIDE POPULATION-BASED COHORT STUDY

2017 ◽  
Vol 69 (11) ◽  
pp. 604
Author(s):  
Mette Glavind Bülow Pedersen ◽  
Morten Olsen ◽  
Morten Schmidt ◽  
Henning B. Laursen ◽  
Søren Johnsen ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
General Population ◽  
Congenital Heart ◽  
Population Based ◽  
Adult Patients

Role of in vivo and in vitro Tests in the Diagnosis of Severe Cutaneous Adverse Reactions (SCAR) to Drug

2019 ◽  
Vol 25 (36) ◽  
pp. 3872-3880 ◽  
Author(s):  
Marcel M. Bergmann ◽  
Jean-Christoph Caubet
Keyword(s):  
Adverse Reactions ◽  
Lymphocyte Transformation ◽  
Stevens Johnson Syndrome ◽  
In Vitro Tests ◽  
High Morbidity ◽  
Patch Tests ◽  
Severe Cutaneous Adverse Reactions ◽  
Cutaneous Adverse Reactions

Severe cutaneous adverse reactions (SCAR) are life-threatening conditions including acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS). Diagnosis of causative underlying drug hypersensitivity (DH) is mandatory due to the high morbidity and mortality upon re-exposure with the incriminated drug. If an underlying DH is suspected, in vivo test, including patch tests (PTs), delayed-reading intradermal tests (IDTs) and in vitro tests can be performed in selected patients for which the suspected culprit drug is mandatory, or in order to find a safe alternative treatment. Positivity of in vivo and in vitro tests in SCAR to drug varies depending on the type of reaction and the incriminated drugs. Due to the severe nature of these reactions, drug provocation test (DPT) is highly contraindicated in patients who experienced SCAR. Thus, sensitivity is based on positive test results in patients with a suggestive clinical history. Patch tests still remain the first-line diagnostic tests in the majority of patients with SCAR, followed, in case of negative results, by delayed-reading IDTs, with the exception of patients with bullous diseases where IDTs are still contra-indicated. In vitro tests have shown promising results in the diagnosis of SCAR to drug. Positivity is particularly high when the lymphocyte transformation test (LTT) is combined with cytokines and cytotoxic markers measurement (cyto-LTT), but this still has to be confirmed with larger studies. Due to the rarity of SCAR, large multi-center collaborative studies are needed to better study the sensitivity and specificity of in vivo and in vitro tests.

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