By W.J. Pichler
Drug hypersensitivities are immune-mediated reactions characterised by means of exanthems, fever and inner organ involvement. They symbolize a difficult box of analysis: many various medications can result in quite a few scientific indicators via a number of mechanisms of drug-host interplay, a lot of that are poorly understood. this is often the 1st ebook to technique the phenomenon of drug hypersensitive reaction in a accomplished demeanour. in addition to epidemiological points, it addresses the immunological mechanisms underlying those complex reactions which move a long way past the IgE-mediated drug asthma additionally thought of within the ebook. moreover, the ebook covers medical manifestations and new diagnostic equipment, and introduces a few lately proven animal types. Well-accepted and in addition thoroughly new options are offered and mentioned intimately. Many subject matters are taken care of from a number of views, and the 33 chapters are completely cross-referenced. This e-book should be of sizeable worth not just to allergologists, dermatologists and a person prescribing drugs, but in addition to scientists in a pharmaceutical challenged via the industrial results of disasters in drug improvement or drug elimination from the marketplace. Elucidating the mechanisms of drug hypersensitive reaction won't merely support to spot sufferers in danger yet also will offer novel insights into the pathophysiology of various immune-mediated ailments.
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Proc Natl Acad Sci USA 2005;102: 4134–4139. 48 Lonjou C, Sekula P, Ledger N, Borot N, de Toma C, Halevy S, Schumacher M, Roujeau JC, Hovnanian A, Mockenhaupt M: A European genetic study of Stevens-Johnson syndrome and toxic epidermal necrolysis: HLA-B association with specific high risk drugs. J Invest Dermatol 2006; 126:37. PD Dr. Maja Mockenhaupt Dokumentationszentrum schwerer Hautreaktionen Department of Dermatology University Medical Center Freiburg, Hauptstrasse 7 DE–79104 Freiburg (Germany) Tel.
Pharmacogenomics J 2006; 6:265–268. 47 Hung SI, Chung WH, Liou LB, Chu CC, Lin M, Huang HP, Lin YL, Lan JL, Yang LC, Hong HS, Chen MJ, Lai PC, Wu MS, Chu CY, Wang KH, Chen CH, Fann CS, Wu JY, Chen YT: HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol. Proc Natl Acad Sci USA 2005;102: 4134–4139. 48 Lonjou C, Sekula P, Ledger N, Borot N, de Toma C, Halevy S, Schumacher M, Roujeau JC, Hovnanian A, Mockenhaupt M: A European genetic study of Stevens-Johnson syndrome and toxic epidermal necrolysis: HLA-B association with specific high risk drugs.
A possible interaction of infection and medication as well as the interaction of different drugs have not yet been clarified. To 23 Lamotrigine (n = 14) 9 8 Number of cases 7 6 5 4 3 2 1 Fig. 1. Time latency between beginning of drug use and onset of SJS/ TEN. Example of a ‘highly suspected’ drug. 0 1–7 date, there is no reliable in vitro or in vivo test to determine the link between a specific drug and the SCAR in a single case. Even by undertaking a provocation test with the suspected drug, the reaction could be induced again in not more than 1 of 10 patients with previous TEN .