Immediate-Type PPI Hypersensitivity as a Severe Adverse Drug Reaction: Diagnostic Challenges, Cross-Reactivity, and Real-Life Outcomes - PubMed
5 hours ago
- #drug hypersensitivity
- #cross-reactivity
- #proton pump inhibitors
- Immediate-type hypersensitivity reactions (HSRs) to proton pump inhibitors (PPIs) are severe adverse drug reactions with diagnostic and management challenges.
- The study involved 40 patients, mostly female (87.5%), with lansoprazole being the most frequent culprit PPI (50%). Anaphylaxis occurred in 65% of cases.
- Skin tests were positive in 25% of patients, with a shorter interval from reaction to testing associated with higher positivity rates (p = 0.025).
- Cross-reactivity (CR) was detected in 25% of patients, most commonly between lansoprazole and pantoprazole.
- Drug provocation testing (DPT) identified safe alternative PPIs for all 29 patients who underwent the test.
- In real-life follow-up, 40.7% of patients restarted PPIs without recurrence, while 55.6% did not restart therapy due to various reasons, including drug-related anxiety.
- The study highlights the importance of early evaluation for skin test sensitivity and addresses behavioral and clinician-related barriers in PPI allergy management.