Identifying the Culprit Drug in Severe Cutaneous Adverse Reactions (SCARs)

2021 ◽  
Author(s):  
Rosario Cabañas ◽  
Elena Ramírez ◽  
Teresa Bellón
Keyword(s):  
Adverse Reactions ◽  
Culprit Drug ◽  
Severe Cutaneous Adverse Reactions ◽  
Cutaneous Adverse Reactions

Role of in vivo and in vitro Tests in the Diagnosis of Severe Cutaneous Adverse Reactions (SCAR) to Drug

2019 ◽  
Vol 25 (36) ◽  
pp. 3872-3880 ◽  
Author(s):  
Marcel M. Bergmann ◽  
Jean-Christoph Caubet
Keyword(s):  
Adverse Reactions ◽  
Lymphocyte Transformation ◽  
Stevens Johnson Syndrome ◽  
In Vitro Tests ◽  
High Morbidity ◽  
Patch Tests ◽  
Severe Cutaneous Adverse Reactions ◽  
Cutaneous Adverse Reactions

Severe cutaneous adverse reactions (SCAR) are life-threatening conditions including acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS). Diagnosis of causative underlying drug hypersensitivity (DH) is mandatory due to the high morbidity and mortality upon re-exposure with the incriminated drug. If an underlying DH is suspected, in vivo test, including patch tests (PTs), delayed-reading intradermal tests (IDTs) and in vitro tests can be performed in selected patients for which the suspected culprit drug is mandatory, or in order to find a safe alternative treatment. Positivity of in vivo and in vitro tests in SCAR to drug varies depending on the type of reaction and the incriminated drugs. Due to the severe nature of these reactions, drug provocation test (DPT) is highly contraindicated in patients who experienced SCAR. Thus, sensitivity is based on positive test results in patients with a suggestive clinical history. Patch tests still remain the first-line diagnostic tests in the majority of patients with SCAR, followed, in case of negative results, by delayed-reading IDTs, with the exception of patients with bullous diseases where IDTs are still contra-indicated. In vitro tests have shown promising results in the diagnosis of SCAR to drug. Positivity is particularly high when the lymphocyte transformation test (LTT) is combined with cytokines and cytotoxic markers measurement (cyto-LTT), but this still has to be confirmed with larger studies. Due to the rarity of SCAR, large multi-center collaborative studies are needed to better study the sensitivity and specificity of in vivo and in vitro tests.

In Vitro Immunologic Tests in Severe Cutaneous Adverse Reactions (SCARs)

2015 ◽  
Vol 11 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Grzegorz Porebski ◽  
Laurence Valeyrie-Allanore ◽  
Francois Berrehar ◽  
Sabine Gouvello
Keyword(s):  
Adverse Reactions ◽  
Severe Cutaneous Adverse Reactions ◽  
Cutaneous Adverse Reactions ◽  
Immunologic Tests

Genetic susceptibilities and prediction modeling of carbamazepine and allopurinol-induced severe cutaneous adverse reactions in Vietnamese

2020 ◽  
Author(s):  
Dinh van Nguyen ◽  
Hieu Chi Chu ◽  
Christopher Vidal ◽  
Richard B Fulton ◽  
Nguyet Nhu Nguyen ◽  
...  
Keyword(s):  
Adverse Reactions ◽  
Surrogate Marker ◽  
Hypersensitivity Syndrome ◽  
Stevens Johnson Syndrome ◽  
Strongly Correlated ◽  
Drug Induced ◽  
Johnson Syndrome ◽  
Severe Cutaneous Adverse Reactions ◽  
Systemic Symptoms ◽  
Cutaneous Adverse Reactions

Aims: To determine genetic susceptibility markers for carbamazepine (CBZ) and allopurinol-induced severe cutaneous adverse reactions (SCARs) in Vietnamese. Methods: A case control study was performed involving 122 patients with CBZ or allopurinol induced SCARs and 120 drug tolerant controls. Results: HLA-B*58:01 was strongly associated with allopurinol-induced SCARs and strongly correlated with SNP rs9263726. HLA-B*15:02 was associated with CBZ-induced Stevens–Johnson syndrome/toxic epidermal necrolysis but not with drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms. No association was found between HLA-A*31:01 and CBZ-induced SCARs. HLA-B*58:01 and rs3909184 allele A with renal insufficiency were shown to increase the risk of allopurinol-induced SCARs. Conclusion: HLA-B*58:01 and HLA-B*15:02 confer susceptibility to allopurinol-induced SCARs and CBZ-induced SJS/TEN in Vietnamese. Single nucleotide polymorphism rs9263726 can be used as a surrogate marker in identifying HLA-B*58:01.

Extracellular Vesicles from Human Plasma Show a Distinctive Proteome and miRNome Profile in Patients with Severe Cutaneous Adverse Reactions

2021 ◽  
Author(s):  
Orlando Salinas-Jaramillo ◽  
Alejandra Monroy-Arreola ◽  
Sebastian Herrera-Noreña ◽  
Ana L. Guzmán-Ortiz ◽  
Abrahan Hernández-Hernández ◽  
...  
Keyword(s):  
Human Plasma ◽  
Extracellular Vesicles ◽  
Adverse Reactions ◽  
Severe Cutaneous Adverse Reactions ◽  
Cutaneous Adverse Reactions

Genetic variants associated with severe cutaneous adverse reactions induced by carbamazepine

2021 ◽  
Author(s):  
Nontaya Nakkam ◽  
Parinya Konyoung ◽  
Warayuwadee Amornpinyo ◽  
Niwat Saksit ◽  
Somsak Tiamkao ◽  
...  
Keyword(s):  
Genetic Variants ◽  
Adverse Reactions ◽  
Severe Cutaneous Adverse Reactions ◽  
Cutaneous Adverse Reactions
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