Drug Hypersensitivity Syndrome in a West-Indian population.
Some studies have suggested an ethnic susceptibility to Hypersensitivity Syndrome. We did a 7-year-prospective study in Guadeloupe whose population is mainly of African ancestry, and has free access to modern care facilities. Most patients included were Afro-Caribbeans (26/28), and females (20/28). However, ethnic distribution did not reach significant conclusions. Annual incidence rate was estimated at 0.9/100,000. Medium incubation and duration were 33 and 66 days respectively. Two patients with grade 4 hepatitis died from the syndrome. Two thirds of the patients were given prednisone, which usually alleviated the systemic symptoms, but did not prevent their development (in 5 patients) nor death. Carbamazepine, allopurinol, and minocycline accounted for 2/3 of the cases. Sixty four percent of the causative prescriptions were judged inappropriate. DHS appeared as the most frequent type of severe systemic drug reaction in this population, and may largely be prevented by rational prescribing.
Muller
Philippe
P
Dermatology Department, University Hospital, BP 465, 97159 Pointe à Pitre, Guadeloupe, French West-Indies. philippe.muller@chu-guadeloupe.fr
Dubreil
Patrick
P
Mahé
Antoine
A
Lamaury
Isabelle
I
Salzer
Birgit
B
Deloumeaux
Jacqueline
J
Strobel
Michel
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000009:adverse effects; D002220:Carbamazepine / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D005260:Female; D006074:Gout Suppressants / Q000009:adverse effects; D019430:Guadeloupe / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008508:Medication Errors / Q000009:adverse effects*; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects; D011241:Prednisone / Q000627:therapeutic use; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000927:Anticonvulsants; D006074:Gout Suppressants; D002220:Carbamazepine; D000493:Allopurinol; D008911:Minocycline; D011241:Prednisone