Objective: In the present study we aimed allergy testing to LA is justified in patients with a positive history of hypersensitivity reactions to drugs additionally by atopy and atopic diseases.
Methods:The study was conducted among patients admitted to our allergy clinic who gave a reliable history of urticaria/angioedema, nasoocular symptoms and bronchospasm after ingesting drugs. A standard questionnaire regarding demographic data, history of atopic disease (asthma, allergic rhinitis, atopic dermatitis, urticaria) was filled out, total IgE and eosinophil count were assesed for each patient. Skin prick tests (SPT), intradermal test (IDT) and subcutaneus incremental challenge test (ICT) were perfomed step by step with adrenaline free lidokain and prilokain.
Results:239 patients (63men,176 women) with history of drug allergy were admitted. Asthma prevalence, atopy rate and mean total IgE levels are found higher in the study. When we look at the results of skin tests and provocations with LA; while positive results of SPT werent found, 3 of IDT and 4 of ICT were positive. Of the all 4 patients that reacted to LA, had rhinosinusitis and a positive SPT reaction with aeroallergens, 1 patient had also food allergy, 2 patient had asthma. Although eosinofil counts were normal, 2 patient had high level of total Ig E.
Conclusion: There is no increased risk requiring performing skin and provocation test for LA in the patients with a history of hypersensitivity reaction to drugs alone but additionally by presence of atopy, atopic disease and multidrug allergy history can increase the risk of LA allergy, the amount of evidence is scarce.