title: Actual drug allergy during childhood: Five years' experience at a tertiary referral centre.
abstract: BACKGROUND
  Drug hypersensitivity reactions (DHR) are common in the paediatric population, representing a public health problem. Recent studies have confirmed that the frequency of drug allergy is overestimated by both parents and physicians. The aim of this study is to determine the prevalence and risk factors of actual drug allergies in children admitted to a tertiary referral allergy centre.
  
  
  METHODS
  Medical records covering the period of 2005-2010 of children with a history of DHR were reviewed. Demographic features of the patients and results of skin and drug provocation tests were noted. The European Network for Drug Allergy (ENDA) questionnaire was filled by using medical records and making phone calls with parents.
  
  
  RESULTS
  Ninety-six patients with 140 DHRs were evaluated. Seventeen children had confirmed drug allergy by positive skin tests (n=11) and drug provocation tests (n=5). One patient underwent severe anaphylaxis and subsequent cardiac arrest during infusion of the drug, and therefore diagnostic tests were not performed. Actual drug allergy was more frequent in children with chronic diseases (58.8% vs. 26.5%, p=0.018) and histories of anaphylaxis during DHR (58.8% vs. 24%, p=0.001). The patients' history of anaphylaxis [OR: 5.789, 95%CI: 1.880-17.554, p=0.002], sweating [OR: 7.8, 95%CI: 1.041-58.443, p=0.046] and dyspnoea [OR: 5.230, 95%CI: 1.836-14.894, p=0.002] during suspicious DHRs increased the risk for actual drug allergy.
  
  
  CONCLUSIONS
  Actual drug allergy was determined in 17.7% of the patients with a suspicious DHR. Having a history of anaphylaxis during suspected drug reactions as well as symptoms of sweating and dyspnoea increased the risk for actual drug allergy.
authors.affiliation: Hacettepe University, School of Medicine, Department of Pediatrics, 06100 Ankara, Turkey.
authors.forename: G D
authors.initials: GD
authors.lastname: Tugcu
authors.affiliation: Hacettepe University, School of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Cavkaytar
authors.affiliation: Hacettepe University, School of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey.
authors.forename: B E
authors.initials: BE
authors.lastname: Sekerel
authors.affiliation: Hacettepe University, School of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Sackesen
authors.affiliation: Hacettepe University, School of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Kalayci
authors.affiliation: Hacettepe University, School of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Tuncer
authors.affiliation: Hacettepe University, School of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: ozgeusoyer@gmail.com.
authors.forename: O
authors.initials: O
authors.lastname: Soyer
mesh_terms: D000485:Allergens / Q000008:administration & dosage* / Q000009:adverse effects; D000707:Anaphylaxis / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology*; D004417:Dyspnea; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012882:Skin Tests; D013546:Sweating; D062606:Tertiary Care Centers; D047090:beta-Lactams / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000485:Allergens; D047090:beta-Lactams
keywords: Diagnosis; Drug allergy; Drug hypersensitivity reaction; Epidemiology; Risk factor