PMID- 33178561 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231112 IS - 2233-8276 (Print) IS - 2233-8268 (Electronic) IS - 2233-8276 (Linking) VI - 10 IP - 4 DP - 2020 Oct TI - Diagnostic procedures & practices in drug allergy/hypersensitivity: a survey of 13 Asian countries. PG - e36 LID - 10.5415/apallergy.2020.10.e36 [doi] LID - e36 AB - BACKGROUND: The issues and challenges in the diagnosis of drug allergy/hypersensitivity among children and adults in Asia are likely to be different from non-Asian countries. OBJECTIVE: To study the diagnostic modalities used in the evaluation and management of drug allergy/drug hypersensitivity reactions (DHRs) among member societies of the Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI). METHODS: A questionnaire comprising 41 questions was circulated electronically to member societies and individual members of APAAACI between January 23, 2020 and March 6, 2020. RESULTS: Twenty-six respondents from 15 member societies and 1 individual member responded. European DHR guidelines were most commonly used. Skin prick and intradermal testing was used by 100%, with only 60% having access to commercial penicillin skin test reagents. In vitro-speci fi c IgE tests were used by 75%, and basophil activation test by 56.3% for immediate DHR. Patch tests were used by 75% in contrast to lymphocyte transformation tests by 25% for nonimmediate DHR. Drug provocation tests were used by 68.8%, the most common indication being to exclude hypersensitivity where history/symptoms were not suggestive of drug hypersensitivity/allergy (93.3%). Human leukocyte antigen (HLA) genotype testing was mandatory among 25% respondents before new carbamazepine prescriptions, and 8.3% for allopurinol prescriptions. CONCLUSIONS: There was increased use of skin testing for iodinated contrast media hypersensitivity and patch testing for nonimmediate DHR. HLA genotype testing prior to new carbamazepine, allopurinol and abacavir prescriptions remain variable despite strong associations for severe cutaneous adverse reactions with Asian ethnicity. Results of this survey form a useful framework for developing educational and training needs and for improving access to drug allergy diagnostic and treatment modalities across APAAACI member societies. CI - Copyright (c) 2020. Asia Pacific Association of Allergy, Asthma and Clinical Immunology. FAU - Tang, Min-Moon AU - Tang MM AUID- ORCID: 0000-0001-7760-3238 AD - Hospital Kuala Lumpur, Kuala Lumpur, Malaysia. FAU - Fok, Jie Shen AU - Fok JS AUID- ORCID: 0000-0002-3450-0877 AD - Department of Respiratory Medicine, Box Hill Hospital, Eastern Health, Melbourne, Victoria, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne, Australia. FAU - Thong, Bernard Yu-Hor AU - Thong BY AUID- ORCID: 0000-0002-6338-8482 AD - Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore. FAU - Yun, James AU - Yun J AUID- ORCID: 0000-0002-3482-5663 AD - Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Division of Medicine, Nepean Hospital, Sydney, Australia. FAU - Li, Philip Hei AU - Li PH AUID- ORCID: 0000-0002-9155-9162 AD - Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong. FAU - Kang, Hye-Ryun AU - Kang HR AUID- ORCID: 0000-0002-2317-4201 AD - Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Drug Safety Center, Seoul National University Hospital, Seoul, Korea. FAU - Thien, Francis AU - Thien F AUID- ORCID: 0000-0003-0925-6566 AD - Eastern Health, Melbourne; Monash University, Melbourne, Australia. FAU - Yamaguchi, Masao AU - Yamaguchi M AUID- ORCID: 0000-0001-6167-0591 AD - Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan. FAU - Lucas, Michaela AU - Lucas M AUID- ORCID: 0000-0001-8881-9990 AD - Department of Immunology, Pathwest and Sir Charles Gairdner Hospital, Perth, Australia; Medical School, University of Western Australia, Perth, Australia. FAU - Chang, Yoon-Seok AU - Chang YS AUID- ORCID: 0000-0003-3157-0447 AD - Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. FAU - Kim, Byung-Keun AU - Kim BK AUID- ORCID: 0000-0001-5147-6306 AD - Department of Internal Medicine, Korea University Medical Center Anam Hospital, Seoul, Korea. FAU - Nagao, Mizuho AU - Nagao M AUID- ORCID: 0000-0003-3557-8761 AD - Allergy Center of Mie National Hospital, Tsu, Japan. FAU - Rengganis, Iris AU - Rengganis I AUID- ORCID: 0000-0001-8748-8544 AD - Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. FAU - Tsai, Yi-Giien AU - Tsai YG AUID- ORCID: 0000-0002-6744-1682 AD - School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. FAU - Chung, Wen-Hung AU - Chung WH AUID- ORCID: 0000-0003-1681-0959 AD - Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Keelung and Linkou Branches, College of Medicine, Chang Gung University, Taipei, Taiwan. FAU - Rerkpattanapipat, Ticha AU - Rerkpattanapipat T AUID- ORCID: 0000-0002-6630-2795 AD - Allergy, Immunology and Rheumatology Division, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. FAU - Kamchaisatian, Wasu AU - Kamchaisatian W AUID- ORCID: 0000-0003-0839-7682 AD - Pediatric Allergy and Immunology Division, Samitivej Children's Hospital, Bangkok, Thailand. FAU - Leung, Ting Fan AU - Leung TF AUID- ORCID: 0000-0002-6469-1926 AD - Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong. FAU - Ho, Joo-Yoon AU - Ho JY AUID- ORCID: 0000-0002-4645-4863 AD - Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. FAU - Zhang, Luo AU - Zhang L AUID- ORCID: 0000-0002-0910-9884 AD - Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China. FAU - Latiff, Amir Hamzah Abdul AU - Latiff AHA AUID- ORCID: 0000-0002-6304-0494 AD - Allergy & Immunology Centre, Pantai Hospital, Kuala Lumpur, Malaysia. FAU - Fujisawa, Takao AU - Fujisawa T AUID- ORCID: 0000-0002-9196-9436 AD - Allergy Center of Mie National Hospital, Tsu, Japan. FAU - Castells, Mariana C AU - Castells MC AUID- ORCID: 0000-0001-6451-0163 AD - Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Mastocytosis Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. FAU - Demoly, Pascal AU - Demoly P AUID- ORCID: 0000-0001-7827-7964 AD - Division of Allergy, Department of Pulmonology, Hopital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France; UPMC Univ Paris 06, UMRS 1136, Equipe - EPAR - IPLESP, Sorbonne Universites, Paris, France. FAU - Wang, Jiu Yao AU - Wang JY AUID- ORCID: 0000-0003-4540-9822 AD - Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan. FAU - Pawankar, Ruby AU - Pawankar R AUID- ORCID: 0000-0002-3091-7237 AD - Department of Pediatrics, Nippon Medical School, Tokyo, Japan. LA - eng PT - Journal Article DEP - 20201015 PL - Netherlands TA - Asia Pac Allergy JT - Asia Pacific allergy JID - 101561954 PMC - PMC7610088 OTO - NOTNLM OT - Anaphylaxis OT - Contrast media OT - Penicillins OT - Pharmacogenetics, Skin tests COIS- Conflict of Interest: The authors have no financial conflicts of interest. EDAT- 2020/11/13 06:00 MHDA- 2020/11/13 06:01 PMCR- 2020/10/01 CRDT- 2020/11/12 05:44 PHST- 2020/09/29 00:00 [received] PHST- 2020/10/10 00:00 [accepted] PHST- 2020/11/12 05:44 [entrez] PHST- 2020/11/13 06:00 [pubmed] PHST- 2020/11/13 06:01 [medline] PHST- 2020/10/01 00:00 [pmc-release] AID - 2020100403 [pii] AID - 10.5415/apallergy.2020.10.e36 [doi] PST - epublish SO - Asia Pac Allergy. 2020 Oct 15;10(4):e36. doi: 10.5415/apallergy.2020.10.e36. eCollection 2020 Oct.