title: Immediate and Delayed Hypersensitivity Reactions to Proton Pump Inhibitors: Evaluation and Management.
abstract: PPIs are among the most commonly administered medications in the USA and are generally well tolerated. Immediate and delayed immune-mediated hypersensitivity reactions are rare but increasingly recognized adverse effects of proton pump inhibitors (PPIs). Immediate hypersensitivity reactions can occur due to IgE-mediated hypersensitivity to PPIs and can be evaluated by immediate hypersensitivity skin testing and oral provocation challenge testing. A desensitization protocol can be used when PPI use cannot be avoided in an allergic patient. Delayed hypersensitivity reactions to PPIs have also been reported. Occupational exposures causing cutaneous reactions to PPIs are the most commonly reported delayed hypersensitivity reaction, followed by drug-induced subacute cutaneous lupus erythematosus. This review presents a summary of the clinical presentation, diagnostic evaluation, and management of immune-mediated hypersensitivity reactions to PPIs.
authors.affiliation: Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, USA. iotani@mgh.harvard.edu.
authors.forename: Iris M
authors.initials: IM
authors.lastname: Otani
authors.affiliation: Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, USA. abanerji@mgh.harvard.edu.
authors.forename: Aleena
authors.initials: A
authors.lastname: Banerji
mesh_terms: D000818:Animals; D004342:Drug Hypersensitivity / Q000175:diagnosis; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy*; D006969:Hypersensitivity, Immediate / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy*; D008178:Lupus Erythematosus, Cutaneous / Q000150:complications; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012882:Skin Tests / Q000009:adverse effects
chemical_list: D054328:Proton Pump Inhibitors
keywords: Adverse drug reaction; Drug allergy; Hypersensitivity reaction; PPI; Patch testing; Proton pump inhibitor; Skin testing
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