Drug allergy - top articles for May/June 2014

Here are my suggestions for some of the top articles about drug allergy for May/June 2014:

Progressive increase in ACEi use has led to a parallel increase in angioedema, with different degrees of severity. ACEI-induced angioedema is associated with high levels of bradykinin and preferentially occurs in females and African-Americans. Less than 10% of patients with ACEI-associated angioedema also develop angioedema episodes after ARB intake. Therefore, ARBs may be reserved for patients with high therapeutic need for angiotensin inhibition. http://buff.ly/17fkvvx

"Most patients with angioedema related to ACE inhibitor usually tolerate ARBs". The operative word is "most". http://buff.ly/NankbP

Nonimmediate reactions to contrast media are T-cell mediated. Provocation testing is needed to find a tolerated agent http://buff.ly/1208TY3

Allergists were able exclude antibiotic allergy in more than 90% of children who had a negative intradermal test (via a challenge) http://buff.ly/1dgFeQz



Classification of adverse reactions to drugs, using the "SOAP III" mnemonic (click to enlarge the image).

Immediate-type hypersensitivity reactions to proton pump inhibitors (PPIs): skin test is useful http://buff.ly/13zmRkh

Diagnosis of penicillin allergy revisited: 7-day challenge may yield more positive reactions than standard challenge http://buff.ly/1cdW9qA

Practical approach to management of hypersensitivity to NSAIDs - 2013 EAACI position paper http://buff.ly/GNVDCa

Flu Vaccine Allergy May Be Attributed to Gelatin, Not Egg http://buff.ly/1i0NLPf

The Flu Vaccine Is Safer Than We Knew - Even for children with egg allergies http://buff.ly/1dUj8qK

Prognostic Factors in Severe Cutaneous Drug Reactions http://buff.ly/IjdVMB - Worse with thrombocytopenia in SJS/TEN, leukocytosis in DRESS

NSAID-induced urticaria/angioedema does not evolve into chronic urticaria: a 12-year follow-up study http://buff.ly/1iCVNvU

Drug-Induced Enterocolitis Syndrome (DIES) [Pediatr Allergy Immunol. 2014] http://buff.ly/1eHUJ5b - Switch to a less ominous abbreviation.

Penicillin "allergy" history is self-reported by about 1 out of 10 persons. 19 of 20 patients who think they are allergic to penicillin are misinformed. 9 out of 10 patients who report penicillin allergy are proven to be tolerant when assessed by penicillin skin testing. 30 million people report a penicillin allergy in the US - 27 million of them are likely not allergic. Hospital length of stay for a patient with a self-reported allergy was 0.59 days longer http://buff.ly/1lFJoIZ



Drug allergy management in 5 steps (click to enlarge the image).

The articles were selected from Twitter @Allergy and RSS subscriptions. Some of the top allergy accounts on Twitter contributed links. I appreciate the curation provided by @Aller_MD @AllergyNet @IgECPD @DrAnneEllis @AACMaven @AllergieVoeding @allergistmommy @mrathkopf @wheezemd.

Please feel free to send suggestions for articles to AllergyGoAway AT gmail DOT com and you will receive an acknowledgement in the next edition of this publication.