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Rapid drug desensitization for immediate hypersensitivity reactions

Authors
Mariana C Castells, MD, PhD
Roland Solensky, MD
Section Editor
N Franklin Adkinson, Jr, MD
Deputy Editor
Anna M Feldweg, MD

INTRODUCTION

Desensitization is a procedure that alters the immune response to the drug and results in TEMPORARY tolerance, allowing the patient with a drug hypersensitivity reaction to receive an uninterrupted course of the medication safely. Once the medication is discontinued, or if treatment is interrupted for a sufficient period of time, the patient's hypersensitivity to the medication returns. Desensitization is only safe and effective for certain types of drug allergy. The terms drug hypersensitivity and drug allergy are used synonymously in this topic review.

Techniques for drug desensitization in patients with immediate hypersensitivity reactions and the proposed mechanisms underlying these techniques will be reviewed here. Desensitizations for reactions to nonsteroidal antiinflammatory drugs (NSAIDs) are NOT included in this discussion, but are discussed elsewhere. (See "Diagnostic challenge and desensitization protocols for NSAID reactions" and "Aspirin-exacerbated respiratory disease: NSAID challenge and desensitization".)

IMMEDIATE DRUG REACTIONS

The World Allergy Organization (WAO) has recommended dividing drug hypersensitivity reactions into two general types [1]:

Immediate reactions – Reactions that begin within one hour of exposure to the culprit drug.

Delayed reactions – Reactions that begin later than one hour after exposure to the culprit drug.

                                       

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Literature review current through: Nov 2016. | This topic last updated: Tue May 05 00:00:00 GMT+00:00 2015.
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