title: The utility of the World Health Organization-The Uppsala Monitoring Centre (WHO-UMC) system for the assessment of adverse drug reactions in hospitalized children.
abstract: Although the World Health Organization-The Uppsala Monitoring Centre (WHO-UMC) system has been suggested as a practical tool for classifying adverse drug reactions (ADRs), verification of such system has not been examined. The objective of this study was to evaluate the usefulness of the WHO-UMC classification for the diagnosis of ADRs. The gold standard was the results of drug challenges and serum tryptase in cases of anaphylaxis. Twenty-seven children had ADRs classified by the WHO-UMC system. The causality terms were 'certain' in 4/27, 'probable' in 6/27, 'possible' in 10/27 and 'unlikely' in 7/27 of the patients. Skin prick tests and intradermal tests were positive in 1/20 and 1/5 of the patients, respectively. Drug challenges and serum tryptase were positive in 8/26 and 1/3 of the patients, respectively. After complete evaluation, the positive and negative ADRs were documented in 9/27 patients (33.33%) and 18/27 patients (66.67%), respectively. The multi-level likelihood ratios for ADRs using the WHO-UMC system were infinity in causality term 'certain', 2 in 'probable', 0.5 in 'possible', and 0 in 'unlikely'. In conclusion, causality term 'certain' and 'unlikely' of the WHO-UMC system had large impact on the likelihood of ADRs. In contrast, the causality term 'probable' and 'possible' had small impact on the likelihood of ADRs. Drug challenges and serum tryptase were helpful to confirm ADRs categorized by WHO-UMC system.
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand,
authors.forename: Chutsumarn
authors.initials: C
authors.lastname: Tantikul
authors.forename: Naruemon
authors.initials: N
authors.lastname: Dhana
authors.forename: Kowit
authors.initials: K
authors.lastname: Jongjarearnprasert
authors.forename: Nualanong
authors.initials: N
authors.lastname: Visitsunthorn
authors.forename: Pakit
authors.initials: P
authors.lastname: Vichyanond
authors.forename: Orathai
authors.initials: O
authors.lastname: Jirapongsananuruk
mesh_terms: D000293:Adolescent; D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D000707:Anaphylaxis / Q000188:drug therapy; D015984:Causality; D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data; D004342:Drug Hypersensitivity / Q000453:epidemiology*; D016903:Drug Monitoring; D064420:Drug-Related Side Effects and Adverse Reactions / Q000145:classification* / Q000453:epidemiology; D005076:Exanthema / Q000188:drug therapy; D005260:Female; D006633:Histamine Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D012882:Skin Tests; D013785:Thailand; D053802:Tryptases / Q000097:blood; D014581:Urticaria / Q000188:drug therapy; D014944:World Health Organization
chemical_list: D006633:Histamine Antagonists; D053802:Tryptases