En overlege ved Seksjon for klinisk farmakologi ved Haukeland universitetssykehus er førsteforfatter i en studie som har forsøkt å karakterisere legemiddelhypersensitvitet i en norsk populasjon med hensyn på involverte legemidler og kliniske reaksjoner. Av 206 pasienter med mistenkt legemiddelhypersensitivitet var de fleste kvinner. Hudsymptomer var de hyppigste forekommende symptomer, men livstruende reaksjoner som anafylaksi ble sett hos 28 % av pasientene. Antibiotika og NSAIDs var de hyppigst impliserte legemidlene. Mistenkt hypersensitivitet for legemidler var testet med hudtester, laboratorieundersøkelser og provokasjonstester. Legemiddelhypersensitivitet var avkreftet hos 81 og bekreftet hos 24 pasienter. Bekreftet toleranse til alternative legemidler, en mulig farmakologisk mekanisme og uavklarte tilfeller var resultatene av utredningen hos de øvrige pasientene.

ABSTRACT:
Background
Drug hypersensitivity reactions (DHRs) represent an important public health problem. Knowledge of their clinical characteristics will provide improved diagnostic approaches to this topic.
Objectives
The aim of the present study was to describe the clinical characteristics of patients with suspected DHRs.
Methods
The medical records of 206 outpatients with suspected DHRs, who consulted a Norwegian allergy centre from January 2005 to December 2009, were investigated in a retrospective study.
Results
Mean age (range) was 44.3 (11–84) years, and 72 % of the patients were women. The most common underlying diseases justifying the use of drugs were infections (49 %) and pain-related diseases (23 %). Antibiotics (53 %), non-steroidal anti-inflammatory drugs (NSAIDs)
(32 %), paracetamol (15 %) and other drugs (46 %), used as monotherapy or combinations, were the most often suspected drugs. Cutaneous symptoms were the most frequently reported symptoms (83 %). Hospitalisation or prolonged hospitalisation was needed in 38 % of the cases, and anaphylaxis was reported in 28 % of all the patients. Skin prick tests were performed in 185 patients, of which 14 patients had positive test results. Drug provocation tests (DPTs) were performed in only 86 patients, six of which had positive reactions. DHRs were confirmed in 24 and rejected in 81 patients. Unsettled cases (39 %) were mainly due to not performing DPTs.
Conclusions
Suspected DHRs occur predominantly in women. The most common manifestations are cutaneous symptoms, but life-threatening reactions justifying hospitalisation may occur. Antibiotics and NSAIDs are the two drug families most frequently suspected.
DPTs need to be included in diagnostic protocols in order to evaluate suspected DHRs.
(Pharmacoepidemiol Drug Saf 2011 May; 20(5): 506-13)