Prevalence of Confirmed Immediate Type Drug Hypersensitivity Reactions Among School Children

Pediatr Allergy Immunol. 2013 Mar;24(2):160-7. doi: 10.1111/pai.12047. Epub 2013 Feb 3.

Abstract

Background: Despite drug-related hypersensitivity reactions are an important health problem, epidemiologic data on drug allergy and hypersensitivity are limited, and studies including diagnostic work-up are scarce. The aim of this study was to determine the actual frequency of immediate type drug hypersensitivity using diagnostic tests in school children with parent-reported drug allergies.

Methods: This study involved three phases. The first phase is a survey of children with a mean age of 12.9 yrs attending grades 6-8 of primary schools with a questionnaire asking drug-related symptoms within 2 h of ingestion. The total population of sixth to eight grade school children was 210,000, and a sample size of 9096 was deemed to be representative of Ankara [(p) = 1.0%, α < 0.05, β = 0.8, (d) = 0.2.] During the second phase, a detailed clinical history was obtained by phone from the parents of children who had positive parent-reported drug allergy. The final stage of the study consisted of a detailed diagnostic work-up of children with a clinical history consistent with immediate type drug hypersensitivity reaction.

Results: Overall, 11,233 questionnaires were distributed, 10,096 of which were retrieved after completion by parents. The rate of parent-reported immediate type drug hypersensitivity was 7.87% (792 children). However, phone survey revealed a clinical history suggestive of drug allergy in only 117 children (1.16%). After further diagnostic work-up, the true frequency of immediate type drug hypersensitivity was 0.11%.

Conclusion: Our results suggest that a positive clinical history is not enough to make a diagnosis of drug allergy, which highlights the significance of undertaking further diagnostic evaluation.

MeSH terms

  • Adolescent
  • Age Factors
  • Biomarkers / blood
  • Chi-Square Distribution
  • Child
  • Cross-Sectional Studies
  • Drug Hypersensitivity / blood
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / epidemiology*
  • Drug Hypersensitivity / immunology
  • Female
  • Health Surveys
  • Humans
  • Hypersensitivity, Immediate / blood
  • Hypersensitivity, Immediate / diagnosis
  • Hypersensitivity, Immediate / epidemiology*
  • Hypersensitivity, Immediate / immunology
  • Immunoglobulin E / blood
  • Intradermal Tests
  • Male
  • Predictive Value of Tests
  • Prevalence
  • Surveys and Questionnaires
  • Telephone
  • Turkey / epidemiology

Substances

  • Biomarkers
  • Immunoglobulin E