154:
Drug-induced urticaria (DIU) and angioedema in Latin American Countries
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Edgardo J. Jares, MD, Mario Sanchez-Borges, MD FAAAAI, R Maximiliano Gomez, MD PhD, Carlos D. Serrano, MD, Luis Felipe C. Ensina, MD, PhD, Ivan Cherrez- Ojeda, MD, Jonathan A. Bernstein, MD FAAAAI, Alicia Mabel De Falco, MD, Mabel Noemi Cuello, MD, Blanca Maria Del Refugio Morfin Maciel, MD FAAAAI, Alfredo Arias Cruz, MD FAAAAI, Ricardo Cardona Villa, Sandra Nora González- Diaz, MD PhD FAAAAI FACAAI, EAACI, Alejandra Macias-Weinmann, MD, Silvana Beatriz Monsell, Galie E. Mimessi, MD, Raul Adolfo Salvatierra, MD, Andrea Zanacchi, Luis F Ramirez Zuluaga, Norma Susana de Barayazarra, MD, Juan F. Schuhl, MD FAAAAI, Paola A. Toche Pinaud, Susana Diez, Miguel Angel Vinuesa, MD, Mara Morelo Rocha Felix, Ada Del Castillo Mendez, MD
RATIONALE:

Urticaria/angioedema are the most frequent clinical manifestations of drug hypersensitivity. However, data from Latin America on this topic is limited.

METHODS:

A retrospective, cross-sectional study assessed characteristics of drug induced urticaria (DIU) and angioedema using the European Network of Drug Allergy questionnaire in 22 allergy units from 11 Latin American countries. Clinical characteristics, demographics, causal relationship with specific drugs, confirmatory diagnostic evaluation, and treatment were assessed.

RESULTS:

From1,031 hypersensitivity drug reactions (HDR) evaluated, 697 (67.6%) met DIU diagnostic criteria. The mean age was 35.4-year-old (1-85); Female:Male for adults >17 y/o was 2.6:1 whereas for children/adolescent 0-17 y/o was 0.87:1 (P<0.0001).

Severe reactions were present in 21.6% of non-atopic and 15% of atopic patients (p<0.05). A history of a previous HDR to the causal drug was present in 13.3% of patients. The most frequently reported DIU inducers were nonsteroidal anti-inflammatory drugs (NSAIDs) (68%) followed by beta lactam (13%) and non-beta lactam (8%) antibiotics. Provocation tests (n=320) were performed in 244 cases (35%) with NSAIDs (68.1%), beta-lactams (12.8%) and non-beta lactam antibiotics (6.6%) being the most frequent drugs challenged. Skin prick (16.6%) and intracutaneous (10.4%) tests were the second and third most frequent diagnostic procedures performed. Antihistamines (79.5%) and corticosteroids (60.1%) were the most frequently prescribed therapies.

CONCLUSIONS:

Female gender predominated in adults but not in children/adolescents. Personal history of atopy was associated with less severe reactions. NSAIDs and antibiotics were the most common drugs implicated. These results provide much needed data on the prevalence and nature of HDRs in Latin America.