Serious Drug Induced Hypersensitivity Reactions among Hospitalized Infants and Children
Rasha Hassan El-Owaidy, Ahmed Rezk Ahmed, Saeid Fawzey Turkey- General Medicine
Background
There are very limited data concerning the epidemiology of drug hypersensitivity in Egypt.
Aim
We sought to investigate the magnitude of serious drug hypersensitivity reactions among hospitalized infants and children in a tertiary hospital over a period of one year.
Patients and Methods
This study is a cross sectional one that was conducted over a period of one year from the middle of October 2020 to the middle of October 2021. The study was carried out in Children’s Hospital, Ain Shams University. We screened for patients with serious drug hypersensitivity reactions among a total of 10440 hospital admissions over a period of 12 months. Positive cases were further assessed with complete clinical and laboratory assessment.
Results
Out of total admissions of 10440 patients over the study period, 35 (0.335%) patients had clinical manifestations of serious drug hypersensitivity reactions. Concerning those 35 patients, they were 21 (60%) males and 14 (40%) females with age ranging between 3 to 193 months with median (IQR) = 50 (24-96) months. Four patients (11.4%) were known to be allergic; with 1(2.9%) having allergic rhinitis, 1 (2.9%) having urticaria, and 2 (5.7%) having cow milk protein allergy. Ten patients (28.6%) had family history of allergic disorders. Eleven patients (31.4%) had manifestations of anaphylaxis, 18 (51.4%) severe urticaria/angioedema, while the remaining 6 (17.1%) had manifestations of Stevens-Johnson syndrome. Concerning results of laboratory investigations, anemia was found in 29 (82.9%) patients, leukocytosis in 9 (25.7%) patients, leukopenia in 8 (22.9%) patients and thrombocytosis in 4 (11.4%) patients, while none of them had eosinophilia. CRP and ESR were elevated in 24 (68.6%) and 15 (42.9%) patients respectively. All of the 35 patients could overcome the drug hypersensitivity reaction with proper management
Conclusions
Although rare, drug hypersensitivity reactions represent an important health issue that should be clearly well reported, registered, and properly managed. Further wider scale and multicenter studies are warranted to gather more data and investigate the prevalence of each type of drug hypersensitivity reactions among children including those which are not reported in our study.