PMID- 27838693
OWN - NLM
STAT- MEDLINE
DCOM- 20170223
LR  - 20170817
IS  - 1423-0097 (Electronic)
IS  - 1018-2438 (Linking)
VI  - 171
IP  - 1
DP  - 2016
TI  - Management of Hypersensitivity Reactions to Proton Pump Inhibitors: A 
      Retrospective Experience.
PG  - 54-60
AB  - BACKGROUND: We previously reported perfect specificity and low sensitivity of 
      skin tests in proton pump inhibitor (PPI)-induced immediate hypersensitivity 
      reactions in a prospective multicenter study. Here, in a retrospective study, we 
      aimed to further evaluate the diagnostic workup procedures and characteristics of 
      the patients with suspected PPI hypersensitivity. METHODS: This national 
      multicenter study was conducted as a retrospective chart review of patients with 
      a history of PPI-induced immediate hypersensitivity reaction. A total of 60 
      patients were included. Results of diagnostic workup procedures (standardized 
      skin-prick, intradermal, and oral-provocation tests with PPIs) and the 
      characteristics of the patients were analyzed. RESULTS: Lansoprazole was the most 
      commonly suspected drug with 41 patients (68.3%), followed by pantoprazole in 12 
      patients (20.0%), esomeprazole in 6 (10.0%), rabeprazole in 4 (6.7%), and 
      omeprazole in 1 (1.7%). Anaphylaxis (40 patients, 66.7%) was the most common 
      clinical presentation followed by urticaria (17 patients, 28.3%). Diagnostic skin 
      tests with the culprit PPI were positive in 13/26 patients (50.0%). Diagnostic 
      oral-provocation tests were negative in 6/8 patients; 5 of these 6 patients had 
      skin test results with the culprit PPI, and all were negative. Ten patients had 
      at least 1 cross-reactivity. Extensive cross-reactivity (between >2 PPIs) was 
      detected in 4 patients. CONCLUSIONS: Lansoprazole was the most frequently 
      implicated drug and anaphylaxis was the most frequent manifestation of 
      PPI-induced hypersensitivity reactions. Physicians should be aware of the 
      possible cross-reactivity among PPIs; however, a safe, alternative PPI can 
      usually be detected by a thorough drug allergy workup.
CI  - (c) 2016 S. Karger AG, Basel.
FAU - Kepil Ozdemir, Secil
AU  - Kepil Ozdemir S
AD  - Division of Allergy and Immunology, Diskapi Yildirim Beyazit Training and 
      Research Hospital, Ankara, Turkey.
FAU - Oner Erkekol, Ferda
AU  - Oner Erkekol F
FAU - Unal, Derya
AU  - Unal D
FAU - Buyukozturk, Suna
AU  - Buyukozturk S
FAU - Gelincik, Asli
AU  - Gelincik A
FAU - Dursun, Adile Berna
AU  - Dursun AB
FAU - Karakaya, Gul
AU  - Karakaya G
FAU - Bavbek, Sevim
AU  - Bavbek S
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20161112
PL  - Switzerland
TA  - Int Arch Allergy Immunol
JT  - International archives of allergy and immunology
JID - 9211652
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Cross Reactions/immunology
MH  - Disease Management
MH  - Drug Hypersensitivity/*diagnosis/*immunology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Proton Pump Inhibitors/*adverse effects
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Skin Tests
MH  - Young Adult
EDAT- 2016/11/14 06:00
MHDA- 2017/02/24 06:00
CRDT- 2016/11/14 06:00
PHST- 2016/05/20 00:00 [received]
PHST- 2016/09/20 00:00 [accepted]
PHST- 2016/11/14 06:00 [pubmed]
PHST- 2017/02/24 06:00 [medline]
PHST- 2016/11/14 06:00 [entrez]
AID - 000450952 [pii]
AID - 10.1159/000450952 [doi]
PST - ppublish
SO  - Int Arch Allergy Immunol. 2016;171(1):54-60. doi: 10.1159/000450952. Epub 2016 
      Nov 12.