DR(E)SS TO ABACAVIR CONFIRMED BY PATCH TESTS
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.29021/spdv.72.3.289 |
Resumo: | Abacavir hypersensitivity is a potentially fatal systemic adverse reaction that occurs in 2-9% of exposed patients. Symptoms appear during the first 6 weeks of therapy and are similar to DRESS although usually there is no eosinophilia. Studies have confirmed a positive relation with HLA-B*5701, particularly when only cases confirmed by a positive epicutaneous patch test were considered. This HLA allele is now considered an excellent predictor of abacavir hypersensitivity reaction (55% positive predictive value) and it is mandatory to perform a genetic screening before initiating any HIV treatment with abacavir. We report a case of abacavir hypersensitivity reaction, reminding its clinical resemblance with DRESS and pointing out the differences between these two entities, as well as highlighting the importance of HLA phenotyping before beginning treatment with abacavir and the utility of the patch test in confirming this immunologic reaction and studying its effector mechanisms. |
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DR(E)SS TO ABACAVIR CONFIRMED BY PATCH TESTSDR(E)SS AO ABACAVIR CONFIRMADO POR TESTES EPICUTÂNEOSAbacavirDrug hypersensitivity syndromeHLA-B antigensPatch testsAbacavirAntígenios HLA-BSíndrome de hipersensibilidade a medicamentosTestes epicutâneosAbacavir hypersensitivity is a potentially fatal systemic adverse reaction that occurs in 2-9% of exposed patients. Symptoms appear during the first 6 weeks of therapy and are similar to DRESS although usually there is no eosinophilia. Studies have confirmed a positive relation with HLA-B*5701, particularly when only cases confirmed by a positive epicutaneous patch test were considered. This HLA allele is now considered an excellent predictor of abacavir hypersensitivity reaction (55% positive predictive value) and it is mandatory to perform a genetic screening before initiating any HIV treatment with abacavir. We report a case of abacavir hypersensitivity reaction, reminding its clinical resemblance with DRESS and pointing out the differences between these two entities, as well as highlighting the importance of HLA phenotyping before beginning treatment with abacavir and the utility of the patch test in confirming this immunologic reaction and studying its effector mechanisms.A reacção de hipersensibilidade (HS) ao abacavir é uma doença sistémica, potencialmente fatal, que ocorre em 2-9% dos doentes expostos. Inicia-se nas primeiras 6 semanas de tratamento e assemelha-se clinicamente ao DRESS, no entanto, sem eosinofilia. A relação desta reacção com o HLA-B*5701 foi definitivamente comprovada quando os casos imputáveis ao abacavir foram confirmados com um teste epicutâneo (TE) positivo. O HLA-B*5701 foi considerado um indicador excelente de HS ao abacavir, com um valor preditivo positivo da ordem dos 55%, pelo que actualmente se recomenda a sua pesquisa antes de iniciar qualquer esquema de tratamento com este fármaco. Relata-se um caso de HS ao abacavir, relembrando a sua semelhança clínica com o DRESS e realçando as suas diferenças, bem como a importância da fenotipagem HLA antes de iniciar o tratamento e a utilidade dos TE, tanto na confirmação da etiologia da reacção imunológica como no estudo dos mecanismos efectores.Sociedade Portuguesa de Dermatologia e Venereologia2014-10-12T00:00:00Zjournal articleinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.29021/spdv.72.3.289oai:ojs.revista.spdv.com.pt:article/289Journal of the Portuguese Society of Dermatology and Venereology; Vol 72 No 3 (2014): Julho - Setembro; 411-416Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 72 n. 3 (2014): Julho - Setembro; 411-4162182-24092182-2395reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spdv.com.pt/index.php/spdv/article/view/289https://doi.org/10.29021/spdv.72.3.289https://revista.spdv.com.pt/index.php/spdv/article/view/289/284Ramos, LeonorBrites, M. M.Oliveira, J.Gonçalo, Margaridainfo:eu-repo/semantics/openAccess2022-10-06T12:34:49Zoai:ojs.revista.spdv.com.pt:article/289Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:10:49.678500Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
DR(E)SS TO ABACAVIR CONFIRMED BY PATCH TESTS DR(E)SS AO ABACAVIR CONFIRMADO POR TESTES EPICUTÂNEOS |
title |
DR(E)SS TO ABACAVIR CONFIRMED BY PATCH TESTS |
spellingShingle |
DR(E)SS TO ABACAVIR CONFIRMED BY PATCH TESTS Ramos, Leonor Abacavir Drug hypersensitivity syndrome HLA-B antigens Patch tests Abacavir Antígenios HLA-B Síndrome de hipersensibilidade a medicamentos Testes epicutâneos |
title_short |
DR(E)SS TO ABACAVIR CONFIRMED BY PATCH TESTS |
title_full |
DR(E)SS TO ABACAVIR CONFIRMED BY PATCH TESTS |
title_fullStr |
DR(E)SS TO ABACAVIR CONFIRMED BY PATCH TESTS |
title_full_unstemmed |
DR(E)SS TO ABACAVIR CONFIRMED BY PATCH TESTS |
title_sort |
DR(E)SS TO ABACAVIR CONFIRMED BY PATCH TESTS |
author |
Ramos, Leonor |
author_facet |
Ramos, Leonor Brites, M. M. Oliveira, J. Gonçalo, Margarida |
author_role |
author |
author2 |
Brites, M. M. Oliveira, J. Gonçalo, Margarida |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Ramos, Leonor Brites, M. M. Oliveira, J. Gonçalo, Margarida |
dc.subject.por.fl_str_mv |
Abacavir Drug hypersensitivity syndrome HLA-B antigens Patch tests Abacavir Antígenios HLA-B Síndrome de hipersensibilidade a medicamentos Testes epicutâneos |
topic |
Abacavir Drug hypersensitivity syndrome HLA-B antigens Patch tests Abacavir Antígenios HLA-B Síndrome de hipersensibilidade a medicamentos Testes epicutâneos |
description |
Abacavir hypersensitivity is a potentially fatal systemic adverse reaction that occurs in 2-9% of exposed patients. Symptoms appear during the first 6 weeks of therapy and are similar to DRESS although usually there is no eosinophilia. Studies have confirmed a positive relation with HLA-B*5701, particularly when only cases confirmed by a positive epicutaneous patch test were considered. This HLA allele is now considered an excellent predictor of abacavir hypersensitivity reaction (55% positive predictive value) and it is mandatory to perform a genetic screening before initiating any HIV treatment with abacavir. We report a case of abacavir hypersensitivity reaction, reminding its clinical resemblance with DRESS and pointing out the differences between these two entities, as well as highlighting the importance of HLA phenotyping before beginning treatment with abacavir and the utility of the patch test in confirming this immunologic reaction and studying its effector mechanisms. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-10-12T00:00:00Z |
dc.type.driver.fl_str_mv |
journal article info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.29021/spdv.72.3.289 oai:ojs.revista.spdv.com.pt:article/289 |
url |
https://doi.org/10.29021/spdv.72.3.289 |
identifier_str_mv |
oai:ojs.revista.spdv.com.pt:article/289 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revista.spdv.com.pt/index.php/spdv/article/view/289 https://doi.org/10.29021/spdv.72.3.289 https://revista.spdv.com.pt/index.php/spdv/article/view/289/284 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Dermatologia e Venereologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Dermatologia e Venereologia |
dc.source.none.fl_str_mv |
Journal of the Portuguese Society of Dermatology and Venereology; Vol 72 No 3 (2014): Julho - Setembro; 411-416 Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 72 n. 3 (2014): Julho - Setembro; 411-416 2182-2409 2182-2395 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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