AllergyVolume 58, Issue 9 p. 854-863 Drug provocation testing in the diagnosis of drug hypersensitivity reactions: general considerations W. Aberer, W. Aberer Department of Environmental Dermatology, University of Graz, Graz, Austria;Search for more papers by this authorA. Bircher, A. Bircher Department of Dermatology, Basle, Switzerland;Search for more papers by this authorA. Romano, A. Romano Allergy Service, Catholic University of Rome, Italy;Search for more papers by this authorM. Blanca, M. Blanca Allergy Service, University La Paz, Madrid, Spain;Search for more papers by this authorP. Campi, P. Campi Clinic for Allergy and Immunology, Florence, Italy;Search for more papers by this authorJ. Fernandez, J. Fernandez Allergy Section, Dept. Clin. Med., UMH, Elche, Spain;Search for more papers by this authorK. Brockow, K. Brockow Klinik und Poliklinik für Dermatologie und Allergologie, Muenchen, Germany;Search for more papers by this authorW. J. Pichler, W. J. Pichler Clinic for Rheumatology and Clinical Immunology/Allergology, Inselspital, Bern, Switzerland;Search for more papers by this authorP. Demoly, P. Demoly Maladies Respiratoires-INSERM U454, Hôpital Arnaud de Villeneuve, Montpellier, FranceSearch for more papers by this authorfor ENDA, for ENDA ENDA: European Network for Drug Allergy and the EAACI interest group on drug hypersensitivity with the following additional members: Drs. B. K. Ballmer-Weber, A. Barbaud, B. Bilo, J. Birnbaum, B. Blömecke, A. de Weck, C. Dzviga, M. Drouet, B. Eberlein-König, T. Frew, T. Fuchs, J.L. Guéant, C. Gutgesell, M. Hertl, G. Kanny, A. Kapp, M. Kidon, M. Kowalski, G. Marone, H. Merk, A.D. Moneret-Vautrin, C. Pascual-Marcos, B. Przybilla, E. Rebelo-Gomes, J. Ring, F. Rueff, A. Sabbah, J. Sainte Laudy, M. Sanz, E. Tas, M.J. Torres, D. Vervloet, B. Wedi, B. WüthrichSearch for more papers by this authorthe EAACI interest group on drug hypersensitivity, the EAACI interest group on drug hypersensitivity Department of Environmental Dermatology, University of Graz, Graz, Austria;Search for more papers by this author W. Aberer, W. Aberer Department of Environmental Dermatology, University of Graz, Graz, Austria;Search for more papers by this authorA. Bircher, A. Bircher Department of Dermatology, Basle, Switzerland;Search for more papers by this authorA. Romano, A. Romano Allergy Service, Catholic University of Rome, Italy;Search for more papers by this authorM. Blanca, M. Blanca Allergy Service, University La Paz, Madrid, Spain;Search for more papers by this authorP. Campi, P. Campi Clinic for Allergy and Immunology, Florence, Italy;Search for more papers by this authorJ. Fernandez, J. Fernandez Allergy Section, Dept. Clin. Med., UMH, Elche, Spain;Search for more papers by this authorK. Brockow, K. Brockow Klinik und Poliklinik für Dermatologie und Allergologie, Muenchen, Germany;Search for more papers by this authorW. J. Pichler, W. J. Pichler Clinic for Rheumatology and Clinical Immunology/Allergology, Inselspital, Bern, Switzerland;Search for more papers by this authorP. Demoly, P. Demoly Maladies Respiratoires-INSERM U454, Hôpital Arnaud de Villeneuve, Montpellier, FranceSearch for more papers by this authorfor ENDA, for ENDA ENDA: European Network for Drug Allergy and the EAACI interest group on drug hypersensitivity with the following additional members: Drs. B. K. Ballmer-Weber, A. Barbaud, B. Bilo, J. Birnbaum, B. Blömecke, A. de Weck, C. Dzviga, M. Drouet, B. Eberlein-König, T. Frew, T. Fuchs, J.L. Guéant, C. Gutgesell, M. Hertl, G. Kanny, A. Kapp, M. Kidon, M. Kowalski, G. Marone, H. Merk, A.D. Moneret-Vautrin, C. Pascual-Marcos, B. Przybilla, E. Rebelo-Gomes, J. Ring, F. Rueff, A. Sabbah, J. Sainte Laudy, M. Sanz, E. Tas, M.J. Torres, D. Vervloet, B. Wedi, B. WüthrichSearch for more papers by this authorthe EAACI interest group on drug hypersensitivity, the EAACI interest group on drug hypersensitivity Department of Environmental Dermatology, University of Graz, Graz, Austria;Search for more papers by this author First published: 04 August 2003 https://doi.org/10.1034/j.1398-9995.2003.00279.xCitations: 563 Werner Aberer, Department of Dermatology, University of Graz, Auenbruggerplatz 8, A-8036 Graz, Austria Tel.: +43-316-385 3925 Fax: +43-316-385 3782 E-mail: [email protected] Pascal Demoly, ENDA Secretary, Maladies Respiratoires - INSERM U454, Hôpital Arnaud de Villeneuve, CHU de Montpellier, 34295 Montpellier cedex 5, France Tel: +33-467336127 Fax: +33-467042708 E-mail: [email protected] Werner Pichler, ENDA President, Clinic for Rheumatology and Clinical Immunology/ Allergology, Inselspital, 3010 Bern, Switzerland Tel.: +41-316322264 Fax: +41-313815735 E-mail: [email protected] Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References 1 Bennin B, Apgar JT, Callen JP, McDonald CJ. Guidelines of care for cutaneous adverse drug. J Am Acad Derm 1996; 35: 458–461. 2 Bernstein L, Gruchalla RS, Lee RE, Nicklas RA, Dykewicz MS. Ann Allergy Asthma Immunol 1999; 83: 665–700. 3 Wasserfallen JB, Frei PC. Long-term evaluation of usefulness of skin and incremental challenge tests in patients with history of adverse reaction to local anesthetics. Allergy 1995; 50: 162–165. 4 Gruchalla R. Understanding drug allergies. J Allergy Clin Immunol 2000; 105: 637–644. 5 Blanca M, Fernández J, Robaina CG, Juste S, López Serrano CL, Martíguando EM, Martìnez Melero IM. Consentimiento informado en alergia a medicamentos. Rev Espan Alergol Inmunol Clin 1996; 5: 256–258. 6 Demoly P, Michel FB, Bousquet J. In vivo methods for study of allergy: skin tests, techniques and interpretation. E Middleton, CE Reed, EF Ellis, NF Adkinson, JW Yunginger, eds. 5th edn. Allergy, Principles and Practice. Mosby Co, New York 1998; 430–439. 7 Demoly P, Bousquet J. Epidemiology of drug allergy. Curr Opinion Allergy Clin Immunol 2001; 1: 305–310. 8 Ring J, Brockow K. Adverse drug reactions: Mechanisms and assessment. Eur Surg Res 2002; 34: 170–175. 9 Vieluf D, Przybilla B, Schwerbrock U, Ring J. Oral provocation test in the diagnosis of anaphylactoid reactions to “mild” analgesic preparations. Int Arch Allergy Immunol 1995; 107: 268–271. 10 Bircher AJ. Arzneimittelallergie und Haut. Thieme Verlag Stuttgart 1996. 11 SIAIC (Società Italiana di Allergologia ed Immunologia Clinica). Memorandum SIAIC sulla diagnosi di allergia/intolleranza a farmaci. Giornale Ital Allergol Immunol Clin 1998; 8: 573–575. 12 Gruchalla RS. Clinical assessment of drug-induced disease. Lancet 2000; 28: 1505–1511. 13 de Weck AL. Penicillins and cephalosporins. In: Handbook of Experimental Pharmacology, Vol. 63, Chapter 16, ed. Weck, H Bundgaard. Springer Verlag, Berlin 1983: 423–482. 14 Li Wan Po A, Kendall MJ. Causality assessment of adverse effects. When is re-challenge ethically acceptable? Drug Saftey 2001; 24: 793–799. 15 Johansson SGO, Hourihane JO'B, Bousquet J, Bruijnzeel-Koomen C, Dreborg S, Haahtela T, Kowalski ML, Mygind N, Ring J, van Cauwenberge P, van Hage-Hamsten M, Wüthrich B. Position paper. A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force. Allergy 2001; 56: 813–824. 16 Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients. A meta-analysis of prospective studies. JAMA 1998; 279: 1200–1205. 17 Demoly P, Kropf R, Bircher A, Pichler WJ. Drug hypersensitivity: questionnaire. Allergy 1999; 54: 999–1003. 18 Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy 2002; 57: 45–51. 19 Demoly P, Bousquet J. Drug allergy diagnosis work up. Allergy 2002; 57 ( Suppl. 72 ): 73–60. 20 Romano A, Quaratino D, Di Fonso M, Papa G, Venuti A, Gasbarrini G. A diagnostic protocol for evaluationg nonimmediate reactions to aminopenicillins. J Allergy Clin Immunol 1999; 103: 1186–1190. 21 Stark BJ, Earl HS, Gross GN, Lumry WR, Goodman EL, Sullivan TJ. Acute and chronic desensitization of penicillin-allergic patients using oral penicillin. J Allergy Clin Immunol 1987; 79: 523–532. 22 Gleckman RA, Borrego F. Adverse reactions to antibiotics. Postgrad Med 1997; 101: 97–108. 23 Wolkenstein P, Revuz J. Drug-induced severe skin reactions. Drug Safety 1995; 13: 56–68. 24 Kanwar AJ, Bharija SC, Belhaj MS. Fixed drug eruptions in children: a series of 23 cases with provocative tests. Dermatologica 1986; 172: 315–320. 25 Kauppinen K, Stubb S. Fixed eruptions – causative drugs and challenge tests. Br J Dermatol 1985; 112: 575–578. 26 Casadevall J, Ventura PJ, Mullol J, Picado C. Intranasal challenge with aspirin in the diagnosis of aspirin intolerant asthma: evaluation of nasal response by accoustic rhinometry. Thorax 2000; 55: 921–924. 27 Nizankowska E, Bestynska-Krypel A, Cmiel A, Szczeklik A. Oral and bronchial provocation tests with aspirin for diagnosis of aspirin-induced asthma. Eur Respir J 2000; 15: 863–869. 28 Lehner T. Lignocaine hypersensitivity. Lancet 1971; 10: 127. 29 Hannuksela M, Salu H. The repeated open application test (ROAT). Contact Dermatitis 1986; 14: 221–227. 30 Caduff C, Reinhart WH, Hartmann K, Kuhn M. Allergische Sofortreaktionen auf parenterale Glukokortikosteroide? Analyse von 14 Fällen. Schweiz Med Wochenschr 2000; 130: 977–983. 31 Levine BB. Immunologic mechnisms of penicillin allergy: a haptenic model system for the study of allergic diseases of man. N Engl J Med 1966; 275: 1115–1125. 32 Barbaud A, Goncalo M, Bruynzeel D, Bircher A. Guidelines for performing skin tests with drugs in the investigation of cutaneous adverse drug reactions. Contact Dermatitis 2001; 45: 321–328. 33 Blanca M, Torres MJ, Garcia JJ, Romano A, Mayorga C, de Ramaon E, Vega JM, Miranda A, Juarez C. Natural evolution of skin test sensitivity in patients allergic to betalactam antibiotics. J Allergy Clin Immunol 1999; 103: 918–924. 34 Lopez Serrano MC, Caballero MT, Barranco P, Martinez-Alzamora F. Booster responses in the study of allergic reactions to betalactam antibiotics. J Invest Allergol Clin Immunol 1996; 6: 30–35. 35 Solensky R, Earl HS, Gruchalla RS. Lack of penicillin resensitization in patients with a history of penicillin allergy after receiving repeated penicillin courses. Arch Int Med 2002; 162: 822–826. 36 Toogood JH. Risk of anaphylaxis in patients receiving β-blocker drugs. J Allergy Clin Immunol 1988; 81: 1–5. 37 Verresen L, Waer M, Vanrenterghem Y, Michielsen P. Angiotensin-converting enzyme inhibitors and anaphylactoid reations to high-flux membrane dialysis. Lancet 1990; 336: 1360–1362. 38 Rueff F, Przybilla B, Fuchs T, Gall H, Rakoski J, Stolz W, Vieluf D, für die Arbeitsgruppe Insektengiftallergie. Diagnose und Therapie der Bienen- und Wespengiftallergie. Allergologie 2001; 24: 78–92. 39 Kammerl MC, Schaefer RM, Schweda F, Schreiber M, Riegger GA, Kramer BK. Extracorporal therapy with AN69 membranes in combination with ACE inhibition causing severe anaphylactoid reactions: still a current problem? Clin Nephrol 2000; 53: 486–488. 40 Kaplan AP, Joseph K, Silverberg M. Pathways for bradykinin formation and inflammatory disease. J Allergy Clin Immunol 2002; 109: 195–209. 41 Reidenberg MM, Lowenthal DT. Adverse nondrug reactions. N Engl J Med 1968; 279: 678–679. 42 Idsoe G, Guthe T, Willcox RR, de Weck AL. Nature and extent of penicillin side-reactions, with particular reference to fatalities from anaphylactic shock. Bull WHO 1968; 38: 159–180. 43 Drain KL, Volcheck GW. Preventing and managing drug-induced anaphylaxis. Drug Safety 2001; 24: 843–853. 44 Rieger-Ziegler V, Kränke B, Aberer W. Vergleich der Wertigkeit von in-vitro-Diagnostik, Hauttest und oralem Provokationstest bei Patienten mit Überempfindlichkeit auf Acetylsalicylsäure. Allergologie 1999; 22: 645–649. 45 Hein UR, Chantraine-Hess S, Worm M, Zuberbier T, Henz BM. Evaluation of systemic provocation tests in patients with suspected allergic and pseudoallergic drug reactions. Acta Derm Venereol 1999; 79: 139–142. 46 Ring L, Galosi A, Przybilla B. “Reverse placebo provocation” in the diagnosis of anaphylactoid reactions to local anesthetics. J Allergy Clin Immunol 1986; 77: 225. 47 Sullivan TJ, Ong RC, Gillian LK. Studies of the multiple drug allergy syndrome. J Allergy Clin Immunol 1989; 83: 270. 48 Moneret-Vautrin DA, Kanny G, Morisser M, Beaudouine E, Renaudin JM. Réactions anaphylactoides et cutanées tardives aux produits de contraste iodés: état actuel de la question –évolution des idées. Rev Med Interne 2001; 22: 969–977. 49 Kanny G, Beaudouin E, Moneret-Vautrin DA. IgE-mediated allergy to granisetron and safe use of ondansetron. J Allergy Clin Immunol 2001; 108: 1059–1060. 50 Bredlich RO, Gall H, Peter RU. Arzneimittelexanthem auf Metamizol-Na. Allergologie 1999; 22: 624–626. 51 Nyfeler B, Pichler WJ. The lymphocyte transformation test for the diagnosis of drug allergy: sensitivity and specificity. Clin Exp Allergy 1997; 27: 175–181. 52 de Weck AL, Stadler BM, Urwyler A, Wehner HU, Bühlmann RP. Cellular allergen stimulation test (CAST). Allergy Clin Immunol News 1993; 5: 9–14. 53 Lebel B, Messaad D, Kvedariene V, Rongier M, Bousquet J, Demoly P. Cysteinyl–leukotriene release test (CAST) in the diagnosis of immediate drug reactions. Allergy 2001; 56: 688–692. 54 Kowalski ML, Pawliczak R, Wozniak J, Siuda K, Poniatowska M, Iwaszkiewicz J, Kornatowski T, Kaliner MA. Differential metabolism of arachidonic acid in nasal polyp epithelial cells cultured from aspirin-sensitive and aspirin-intolerant patients. Am J Respir Crit Care Med 2000; 161: 391–398. 55 Sanz ML, Gamboa PM, Antepara I, Uasuf C, Vila L, Garcia-Aviles C, Chazot M, de Weck AL. Flow cytometric basophil activation test by detection of CD63 expression in patients with immediate-type reactions to beta-lactam antibiotics. Clin Exp Allergy 2002; 32: 1–10. 56 Spielberg SP. In vitro assessment of pharmacogenetic susceptibility to toxic drug metabolites in humans. Fed Proc 1984; 43: 2303–2313. 57 Karch FE, Lasagna L. Toward the operational identification of adverse drug reactions. Clin Pharm Ther 1997; 21: 247–254. 58 Girard M. Conclusiveness of rechallenge in the interpretation of adverse drug reactions. Br J Clin Pharmacol 1987; 23: 73–79. 59 Moore N, Biour M, Paux G, Loupi E, Bégaud B, Boismare F, Royer RJ. Adverse drug reaction monitoring: doing it the French way. Lancet 1985; II: 1056–1058. 60 Ahnefeld FW, Barth J, Dick W, Doenicke A, Fuchs T, Gervais H, Laubenthal H, Löllgen H, Lorenz W, Mehrkens HH, Meuret GH, Möllmann H, Piepenbrock S, Przybilla B, Ring J, Schmutzler W, Schultze-Werninghaus G, Schüttler J, Schuster HP, Sefrin P, Tryba M, Zander J, Zenz M. Akuttherapie anaphylaktoider Reaktionen. Internist 1994; 35: 401–412. 61 Calhoun WJ, Dick EC, Schwartz LB, Busse WW. A common cold virus, rhinovirus 16, potentiates airway inflammation after segmental antigen bronchoprovocation in allergic subjects. J Clin Invest 1994; 94: 2200–2208. 62 Yocum MW, Heller AM, Abels RI. Efficacy of intravenous pretesting and antihistamine prophylaxis in radiocontrast media-sensitive patients. J Allergy Clin Immunol 1978; 62: 309–313. 63 Mendelson LM, Ressler C, Rosen JP, Selcow JE. Routine elective penicillin allergy skin testing in children and adolescents: study of sensitization. J Allergy Clin Immunol 1984; 73: 76–81. 64 Pichichero ME, Pichichero DM. Diagnosis of penicillin, amoxicillin, and cephalosporin allergy: Reliability of examination assessed by skin testing and oral challenge. J Pediatrics 1998; 132: 137–143. 65 Blanca M, Fernandez J, Miranda A, Terrados S, Torres MJ, Vega JM, Avila MJ, Perez E, Garcia JJ, Suau R. Cross-reactivity between penicillins and cephalosporins; clinical and immunologic studies. J Allergy Clin Immunol 1989; 83: 381–385. 66 Romano A, Di Fonso M, Papa G, Pietrantonio F, Federico F, Fabrizi G, Venuti A. Evaluation of adverse cutaneous reactions to aminopenicillins with emphasis on those manifested by maculopapular rashes. Allergy 1995; 50: 113–118. 67 Torres MJ, Mayorga C, Leyva L, Guzman AE, Cornejo-Garcia JA, Juarez C, Blanca M. Controlled administration of penicillin to patients with a positive history but negative skin and specific serum IgE tests. Clin Exp Allergy 2002; 32: 270–276. 68 Moneret-Vautrin DA, Gueant JL, Kamel L, Laxenaire MC, El Kholty S, Nicolas JP. Anaphylaxis to muscle relaxants: cross-sensitivity studied by radioimmunoassays compared to intradermal tests in 34 cases. J Allergy Clin Immunol 1988; 82: 745–752. 69 de Weck AL. Critical evaluation of diagnostic methods in drug allergy. In: Allergology, Proc 8th Europ Congr Allergol, Int Congr Series 251. Excerpta Medica, Amsterdam, 1971, pp. 23–30. 70 Venulet J. Role and place of causality assessment. Pharmacoepidemiol Drug Saf 1992; 1: 225–234. 71 Ballmer-Weber BK, Vieths S, Bucher CH, Luttkopf D, Wüthrich B. Hazelnut allergy. Validation of diagnostic procedures on the basis of double-blind placebo-controlled food challenges. Allergologie 2000; 23: 285–291. Citing Literature Volume58, Issue9September 2003Pages 854-863 ReferencesRelatedInformation