Drug Allergy in Children:
A Three-Years Experience at Dr. Kariadi Hospital Semarang
Wistiani*, Galuh H*
*Allergy and Immunology Division, Department of Child Health Faculty of Medicine Diponegoro University/dr. Kariadi Hospital, Semarang, Indonesia
Drug allergy (DA) is an immunologically mediated response to specific agent in a sensitized person. The clinical manifestations of DA are restricted to certain syndromes that are specifically accepted as allergic in nature, which may present as mild to life threatening reactions.
To determine the clinical features of DA.
Patient with clinical history of DA referred to Dr. Kariadi Hospital Semarang between January 2012 to May 2015, under the age of 18 years were retrospectively identified from medical records. Drug allergy was defined as one of drug-related cutaneous reaction pattern and systemic symptoms of an immunologically mediated drug hypersensitivity. Statistic analyses was fisher exact test with statistic significance p < 0.05.
A total of 13 patients, 9 boys (69,2%) and 4 girls (30,8%) were identified. The mean age was 67±SD 54 months. The frequency of severe malnutrition and well-nourished were 3 (23,1%) and 10 (76.9%), respectively. All patients under 60 months of age with DA had neutrophil-lymphocyte count ratio (NLCR) below 6 (7 cases, 53,8%). The most common type was Fixed Drug Eruption (FDE) (23,07%). Other type were Steven-Johnson syndrome (SJS), erythema multiforme (EM) and drug-hypersensitive syndrome (DHS). Antibiotics accounted for more than 50% of all drug implicated in DA 8 cases (61,5%). Four (30,8%) had a previously history of allergy manifestation and only 2 (15,4%) patient with family history of allergy. Eosinophilia from blood smear examination was found in 6 cases of DA (46,2%). All patients with FDE showed normal test of liver function 3 (100%), while non FDE were 10 (40%) with p 0.067. There were no correlation between DA with skin exfoliation and anemia, and also with hypoalbuminaemia. Clinical features of skin exfoliation had no correlation with NLCR. All patient of DA except those with FDE received steroid therapy. Mortality in our study was 7,7%.
Fixed Drug Eruption was the most common type of DA found, with male predominantly affected and antibiotic was the drug most commonly involved.