title: A joint allergist/cardiologist classification for thienopyridines hypersensitivity reactions based on their symptomatic patterns and its impact on the management strategies.
abstract: The role and importance of thienopyridines such as ticlopidine, clopidogrel, and prasugrel is well-established for several indications, ranging from prevention of acute coronary syndromes to percutaneous coronary interventions, where the dual antiplatelet therapy represents the gold standard to avoid denovo coronary stenosis. However, there is a significant cohort of patients with coronary artery disease who may manifest hypersensitivity reactions to thienopyridines. The examination of the various case reports from medical literature leads to identify mainly four clinical patterns of hypersensitivity to thienopyridines which involves more frequently cutaneous, hematologic, and articular tissues, therefore the kind and predominance of clinical symptoms may determine a different clinical approach to overcome or neutralize thienopyridines hypersensitivity.
authors: Pneumology Department Civil Hospital "NinettoMelli"S. Pietro Vernotico, Brindisi, Italy; Section of Allergology and Clinical Immunology, Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari Medical School, Bari, Italy. Electronic address: gf.calogiuri@libero.it.
authors: G F
authors: GF
authors: Calogiuri
authors: Department of Internal Medicine, UAE University, Al-Ain, United Arab Emirates.
authors: S
authors: S
authors: Al-Sowaidi
authors: Section of Allergology and Clinical Immunology, Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari Medical School, Bari, Italy.
authors: E
authors: E
authors: Nettis
authors: Internal Medicine Allergy and Rheumatology Unit, Rimini Hospital, Rimini, Italy.
authors: G
authors: G
authors: Cortellini
authors: Section of Allergology and Clinical Immunology, Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari Medical School, Bari, Italy.
authors: L
authors: L
authors: Macchia
authors: Department of Biomedical Science and Human Oncology, Section of Internal Medicine and Clinical Oncology University of Bari Medical School, Bari, Italy.
authors: A
authors: A
authors: Vacca
authors: Department of Cardiology, University of Patras Medical School, Patras, Achaia, Greece.
authors: N G
authors: NG
authors: Kounis
mesh_terms: D000072223:Allergists; D000072096:Cardiologists; D019468:Disease Management; D004342:Drug Hypersensitivity / Q000145:classification* / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D010819:Physician's Role; D058924:Thienopyridines / Q000009:adverse effects / Q000145:classification*
chemical_list: D058924:Thienopyridines
keywords: Arthritis; Clopidogrel; Exanthema; Hypersensitivity; Prasugrel; Thienopyridines; Ticlopidine; Urticaria