Détail du document
Identifiant
oai:pubmedcentral.nih.gov:1086...
Sujet
Invited ReviewAuteur
Mori, Francesca Liccioli, Giulia Tomei, Leonardo Barni, Simona Giovannini, Mattia Sarti, Lucrezia Pessina, Benedetta Torres, María JoséLangue
enEditeur
World Allergy Organization
Catégorie
The World Allergy Organization Journal
Année
2024
Date de référencement
16/08/2024
Mots clés
viral drugRésumé
The majority of viral rashes occurring during an antibiotic therapy are considered as a drug hypersensitivity reaction (DHR).
Differentiating a viral rash versus a DHR is difficult or even impossible.
In delayed DHRs the interplay between viruses and drugs is summarized according to the recent literature.
The question is if the same reaction will again occur in case of drug re-exposure in absence of the concomitant viral infection because of persistent immune reactivity.
Epstein Barr Virus (EBV) and Human Herpes virus 6 (HHV-6) models are analyzed in case of maculopapular exanthemas (MPEs) and drug reaction with eosinophilia and systemic symptoms (DRESS) over a course of drug therapy.
MPEs are the most common skin manifestation during a viral infection and a concomitant drug therapy.
In type IVb reactions to drugs a hapten/pro-hapten mechanism and a pharmacological interaction (p-i mechanism) are described as the 2 major ways to make T cells response functional.
Rarely the altered repertoire model is involved.
The Human Leukocyte Antigen (HLA) predisposition is an additional essential factor that can facilitate DHR.
In MPEs rarely a DHR is confirmed by allergy testing.
Severity and duration of MPEs, the presence of eosinophilia and systemic symptoms make more reliable the persistent nature of the reaction.
Research on this topic is needed in order to provide the clinicians with instruments to decide when to suspect future reactions upon drug re-exposure even in the absence of a viral infection, because those patients should be investigated by a complete drug allergy work up.
Mori, Francesca,Liccioli, Giulia,Tomei, Leonardo,Barni, Simona,Giovannini, Mattia,Sarti, Lucrezia,Pessina, Benedetta,Torres, María José, 2024, How to manage drug-virus interplay underlying skin eruptions in children, World Allergy Organization
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