Cofactors and Diagnostic Parameters of Drug Hypersensitivity

Drug hypersensitivity reactions (DHRs) represent a significant public health concern, with up to 8% of individuals reporting such reactions. Both true allergies and mislabeling contribute to substantial health risks and economic costs, underscoring the critical need for accurate diagnosis by specialists. This dissertation conducts a comprehensive analysis of suspected DHRs to gather epidemiological data and identify cofactors influencing diagnostic outcomes, while evaluating the efficacy of two novel diagnostic methods: a statistical prediction model and the basophil activation test.

Through logistic regression analysis, several key cofactors were identified that impact the likelihood of confirmed allergies. Factors such as age, obesity, and beta-lactam antibiotic usage were positively correlated with the confirmation of antibiotic allergies. Conversely, female sex, self-reported allergic rhinitis, serum total IgE levels between 100-200 kU/L, and hypertension decreased the likelihood of confirmation. For non-opioid analgesics, atopic dermatitis, high IgE levels, and arterial hypertension were significant positive factors, indicating an increased probability of positive provocation tests.

While there are limitations to relying solely on medical history for diagnosis, the developed cross-validated prediction model offers valuable insights into which cofactors should be integrated into future predictive frameworks. In contrast, the basophil activation test utilizing new allergens showed a significant rate of false positives, compromising its reliability for accurate allergy diagnosis.

Ultimately, this research emphasizes the necessity for a standardized approach to data collection across allergy centers. Such a framework would facilitate the identification of clinical predictors and support the advancement of more effective diagnostic methods for managing DHRs, thereby improving patient care and resource allocation.

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Zitierform:
Kühl, J., 2024. Cofactors and Diagnostic Parameters of Drug Hypersensitivity.
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