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Basal serum tryptase is not a risk factor for immediate‐type drug hypersensitivity during childhood
Author(s) -
Cavkaytar Ozlem,
Karaatmaca Betul,
Arik Yilmaz Ebru,
Sahiner Umit M.,
Sackesen Cansın,
Sekerel Bulent E.,
Soyer Ozge
Publication year - 2016
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12604
Subject(s) - medicine , interquartile range , culprit , anaphylaxis , drug allergy , tryptase , provocation test , allergy , drug , gastroenterology , risk factor , rash , drug eruption , basal (medicine) , immunology , pharmacology , mast cell , pathology , alternative medicine , myocardial infarction , insulin
Background High serum basal tryptase ( sBT ) levels have been identified as a risk factor for both venom‐ and food‐induced severe allergic reactions. The aim of this study was to compare sBT levels in children with different severity of actual drug hypersensitivity reactions ( DHR s) with those of age‐ and sex‐matched controls without any history of DHR s. Method Patients between 0 and 18 years of age with a history of immediate‐type DHR s manifested in 0–6 h after the culprit drug intake were included. Following ENDA (European Network for Drug Allergy) inquiries, patients were evaluated with skin and/or provocation tests to define the actual drug‐hypersensitive patients. Serum BT levels were determined for both patients and controls. Results Of 345 children, 106 patients (30.7%) [(58.5% male), median age (interquartile range) 8.0 years (4.2–12.2)] were diagnosed as drug hypersensitive. Ninety‐eight controls were also included. The sBT levels of drug‐hypersensitive patients with and without anaphylaxis and the control group were similar [2.6 (2.0–3.6) μg/l vs. 2.8 (1.6–4.3) μg/l vs. 2.6 (1.8–3.6) μg/l, respectively, (p > 0.05)]. The sBT levels of the patients with sole cutaneous symptoms 2.8 (1.6–4.3) μg/l, mild anaphylaxis 3.0 (1.9‐4.9) μg/l, and moderate‐to‐severe anaphylaxis 2.6 (2.0–3.6) μg/l were also comparable (p > 0.05). The onset of DHR s [those occurring in 1 h (n = 87) or in 1–6 h (n = 19) after the drug intake], positive results with skin tests with the culprit drug, or the classification of the patients according to different age groups [(0–2 years), (2–6 years), (6–12 years), (12–18 years)] did not correlate with sBT levels. Conclusion The sBT levels in children with actual drug hypersensitivity would not be a risk factor for severe systemic reactions on the contrary to children with allergic reactions to food or insect venom.