Desensitization to drugs in children
Main Article Content
Keywords
adolescent, children, desensitization, drug allergy, drug hypersensitivity, pediatric
Abstract
Better knowledge and understanding about drug desensitization is required in the pediatric population, since there is little literature available about it and the most pediatric desensitization protocols have been adapted from adult instructions.
Aiming to soften this issue and foster the future studies, this article presents a recent review about mechanisms of desensitization, diagnostic tools, and up to date management of drug hypersensitivity reactions in children. Bringing up an overview of pediatric hypersensitivity reactions to chemotherapy, biologic agents, antibiotics, nonsteroidal anti-inflammatory drugs, and vaccines.
References
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16. Castells Guitart MC. Rapid drug desensitization for hypersensitivity reactions to chemotherapy and monoclonal antibodies in the 21st century. J Investig Allergol Clin Immunol. 2014;24(2):72–9. PMid: 24834769
17. Hong DI, Dioun AF. Indications, protocols, and outcomes of drug desensitizations for chemotherapy and monoclonal antibodies in adults and children. J Allergy Clin Immunol Pract. 2014;2(1):13–9; quiz 20. 10.1016/j.jaip.2013.11.007
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21. Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy. 2002 Jan;57(1):45–51. PMid: 11991289.
22. Otani IM, Wong J, Banerji A. Platinum chemotherapy hypersensitivity: Prevalence and management. Immunol Allergy Clin North Am. 2017 Nov;37(4):663–77. 10.1016/j.iac.2017.06.003
23. Otani IM, Lax T, Long AA, Slawski BR, Camargo CA Jr, Banerji A. Utility of risk stratification for paclitaxel hypersensitivity reactions. J Allergy Clin Immunol Pract. 2018 Jul–Aug;6(4):1266–73.e2. 10.1016/j.jaip.2017.08.025
24. Tsao LR, Young FD, Otani IM, Castells MC. Hypersensitivity reactions to platinum agents and taxanes. Clin Rev Allergy Immunol. 2021 Aug 2. 10.1007/s12016-021-08877-y
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26. Vultaggio A, Matucci A, Nencini F, Bormioli S, Vivarelli E, Maggi E. Mechanisms of drug desensitization: Not only mast cells. Front Pharmacol. 2020 Dec 23;11:590991. 10.3389/fphar.2020.590991
27. Castells M. Rapid desensitization for hypersensitivity reactions to medications. Immunol Allergy Clin North Am. 2009 Aug;29(3):585–606. 10.1016/j.iac.2009.04.012.
28. Isabwe GAC, Garcia Neuer M, de Las Vecillas Sanchez L, Lynch DM, Marquis K, Castells M. Hypersensitivity reactions to therapeutic monoclonal antibodies: Phenotypes and endotypes. J Allergy Clin Immunol. 2018 Jul;142(1):159–170.e2. 10.1016/j.jaci.2018.02.018
29. Lopez-Gonzalez P, Madrigal-Burgaleta R, Carpio-Escalona LV, Bernal-Rubio L, Guerra E, Berges-Gimeno MP, et al. Assessment of antihistamines and corticosteroids as premedication in rapid drug desensitization to Paclitaxel: Outcomes in 155 procedures. J Allergy Clin Immunol Pract. 2018 Jul–Aug;6(4):1356–62. 10.1016/j.jaip.2017.11.013
30. Atanaskovic-Markovic M, Gomes E, Cernadas JR, du Toit G, Kidon M, Kuyucu S, et al. Diagnosis and management of drug-induced anaphylaxis in children: An EAACI position paper. Pediatr Allergy Immunol. 2019 May;30(3):269–76. 10.1111/pai.13034
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35. Hong DI, Bankova L, Cahill KN, Kyin T, Castells MC. Allergy to monoclonal antibodies: Cutting-edge desensitization methods for cutting-edge therapies. Expert Rev Clin Immunol. 2012 Jan;8(1):43–52; quiz 53–4. 10.1586/eci.11.75
36. Ensina LF, Aranda CS, de Lacerda AE, Camelo-Nunes I, Sole D, Martins AM, et al. Laronidase hypersensitivity and desensitization in type I mucopolysaccharidosis: A case report. Pediatr Allergy Immunol. 2014;25(5):498–9. 10.1111/pai.12209
37. Aranda CS, Ensina LF, Nunes IC, Mallozi MC, Mendes C, Martins AM, et al. Diagnosis and management of infusion-related hypersensitivity reactions to enzyme replacement therapy for lysosomal diseases: The role of desensitization. J Allergy Clin Immunol Pract. 2016;4(2):354–6. 10.1016/j.jaip.2015.11.012
38. Bekis Bozkurt H, Karakurt T, Cavkaytar O, Arga M. Shortened desensitization leading to a 2-year enzyme replacement therapy with elosulfase alfa. Ann Allergy Asthma Immunol. 2021;127(2):261–2.10.1016/j.anai.2021.04.040
39. Toh TSW, Chong KW, Goh AEN, Goh JCY, Ting TW, Tan ES, et al. Enzyme replacement therapy desensitization in a child with infantile onset Pompe disease. Asian Pac J Allergy Immunol. 2020. 10.12932/AP-060919-0638
40. Huffaker MF, Liu AY, Enns GM, Vijay S, Amor AJ, Adkinson NF Jr. Case series of sebelipase alfa hypersensitivity reactions and successful sebelipase alfa rapid desensitization. JIMD Rep. 2019;49(1):30–6. 10.1002/jmd2.12066
41. Capanoglu M, Dibek Misirlioglu E, Azkur D, Vezir E, Guvenir H, Gunduz M, et al. IgE-mediated hypersensitivity and desensitisation with recombinant enzymes in Pompe disease and Type I and Type VI mucopolysaccharidosis. Int Arch Allergy Immunol. 2016;169(3):198–202. 10.1159/000446154
42. Norton AE, Broyles AD. Management of children with hypersensitivity to antibiotics and monoclonal antibodies. Immunol Allergy Clin North Am. 2017;37(4):713–25. 10.1016/j.iac.2017.07.005
43. Jares EJ, Sánchez-Borges M, Cardona-Villa R, Ensina LF, Arias-Cruz A, Gómez M, et al. Multinational experience with hypersensitivity drug reactions in Latin America. Ann Allergy Asthma Immunol. 2014;113(3):282–9. 10.1016/j.anai.2014.06.019
44. Turvey SE, Cronin B, Arnold AD, Dioun AF. Antibiotic desensitization for the allergic patient: 5 Years of experience and practice. Ann Allergy Asthma Immunol. 2004;92(4):426–32. 10.1016/S1081-1206(10)61778-4
45. Legere HJ 3rd, Palis RI, Rodriguez Bouza T, Uluer AZ, Castells MC. A safe protocol for rapid desensitization in patients with cystic fibrosis and antibiotic hypersensitivity. J Cyst Fibros. 2009;8(6):418–24. 10.1016/j.jcf.2009.08.002
46. Palusci VJ, Kaul A, Lawrence RM, Haines KA, Kwittken PL. Rapid oral desensitization to trimethoprim-sulfamethoxazole in infants and children. Pediatr Infect Dis J. 1996;15(5):456–60. 10.1097/00006454-199605000-00015
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2. Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA, et al. International consensus on drug allergy. Allergy. 2014;69(4):420–37. 10.1111/all.12350
3. Pichler WJ. Delayed drug hypersensitivity reactions. Ann Intern Med. 2003;139(8):683–93. 10.7326/0003-4819-139-8-200310210-00012
4. de Las Vecillas Sánchez L, Alenazy LA, Garcia-Neuer M, Castells MC. Drug hypersensitivity and desensitizations: Mechanisms and new approaches. Int J Mol Sci. 2017;18(6):1316. 10.3390/ijms18061316
5. Picard M, Pur L, Caiado J, Giavina-Bianchi P, Galvão VR, Berlin ST, et al. Risk stratification and skin testing to guide re-exposure in taxane-induced hypersensitivity reactions. J Allergy Clin Immunol. 2016;137(4):1154–64.e12. 10.1016/j.jaci.2015.10.039
6. Giavina-Bianchi P, Galvão VR, Picard M, Caiado J, Castells MC. Basophil activation test is a relevant biomarker of the outcome of rapid desensitization in platinum compounds allergy. J Allergy Clin Immunol Pract. 2017;5(3):728–36. 10.1016/j.jaip.2016.11.006
7. Sloane D, Govindarajulu U, Harrow-Mortelliti J, Barry W, Hsu FI, Hong D, et al. Safety, costs, and efficacy of rapid drug desensitizations to chemotherapy and monoclonal antibodies. J Allergy Clin Immunol Pract. 2016;4(3):497–504. 10.1016/j.jaip.2015.12.019
8. Ang WX, Church AM, Kulis M, Choi HW, Burks AW, Abraham SN. Mast cell desensitization inhibits calcium flux and aberrantly remodels actin. J Clin Invest. 2016;126(11):4103–18. 10.1172/JCI87492
9. McNeil BD, Pundir P, Meeker S, Han L, Undem BJ, Kulka M, Dong X. Identification of a mast-cell-specific receptor crucial for pseudo-allergic drug reactions. Nature. 2015;519(7542):237–41. 10.1038/nature14022
10. Sancho-Serra Mdel C, Simarro M, Castells M. Rapid IgE desensitization is antigen specific and impairs early and late mast cell responses targeting FcεRI internalization. Eur J Immunol. 2011;41(4):1004–13. 10.1002/eji.201040810
11. Oka T, Rios EJ, Tsai M, Kalesnikoff J, Galli SJ. Rapid desensitization induces internalization of antigen-specific IgE on mouse mast cells. J Allergy Clin Immunol. 2013;132(4):922–32. e1–16. 10.1016/j.jaci.2013.05.004
12. Shalit M, Levi-Schaffer F. Challenge of mast cells with increasing amounts of antigen induces desensitization. Clin Exp Allergy. 1995;25(9):896–902. 10.1111/j.1365-2222.1995.tb00033.x
13. Cernadas JR, Brockow K, Romano A, Aberer W, Torres MJ, Bircher A, et al; European network of drug allergy and the EAACI interest group on drug hypersensitivity. General considerations on rapid desensitization for drug hypersensitivity—A consensus statement. Allergy. 2010;65(11):1357–66. 10.1111/j.1398-9995.2010.02441.x
14. Diaferio L, Giovannini M, Clark E, Castagnoli R, Caimmi D. Protocols for drug allergy desensitization in children. Expert Rev Clin Immunol. 2020;16(1):91–100. 10.1080/1744666X.2019.1698294.
15. Caimmi S, Caffarelli C, Saretta F, Liotti L, Crisafulli G, Cardinale F, et al. Drug desensitization in allergic children. Acta Biomed. 2019;90(3-S):20–9. 10.23750/abm.v90i3-S.8158
16. Castells Guitart MC. Rapid drug desensitization for hypersensitivity reactions to chemotherapy and monoclonal antibodies in the 21st century. J Investig Allergol Clin Immunol. 2014;24(2):72–9. PMid: 24834769
17. Hong DI, Dioun AF. Indications, protocols, and outcomes of drug desensitizations for chemotherapy and monoclonal antibodies in adults and children. J Allergy Clin Immunol Pract. 2014;2(1):13–9; quiz 20. 10.1016/j.jaip.2013.11.007
18. Macy E, Ensina LF. Is skin testing required prior to drug challenges? J Allergy Clin Immunol Pract. 2018;7(2):412–7.
19. Soyer O, Sahiner UM, Sekerel BE. Pro and contra: Provocation tests in drug hypersensitivity. Int J Mol Sci. 2017;18(7):1437. 10.3390/ijms18071437
20. Gomes ER, Brockow K, Kuyucu S, Saretta F, Mori F, Blanca-Lopez N, et al. Drug hypersensitivity in children: Report from the pediatric task force of the EAACI Drug Allergy Interest Group. Allergy. 2016 Feb;71(2):149–61. 10.1111/all.12774
21. Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy. 2002 Jan;57(1):45–51. PMid: 11991289.
22. Otani IM, Wong J, Banerji A. Platinum chemotherapy hypersensitivity: Prevalence and management. Immunol Allergy Clin North Am. 2017 Nov;37(4):663–77. 10.1016/j.iac.2017.06.003
23. Otani IM, Lax T, Long AA, Slawski BR, Camargo CA Jr, Banerji A. Utility of risk stratification for paclitaxel hypersensitivity reactions. J Allergy Clin Immunol Pract. 2018 Jul–Aug;6(4):1266–73.e2. 10.1016/j.jaip.2017.08.025
24. Tsao LR, Young FD, Otani IM, Castells MC. Hypersensitivity reactions to platinum agents and taxanes. Clin Rev Allergy Immunol. 2021 Aug 2. 10.1007/s12016-021-08877-y
25. Otani IM, Castells M. Novel roles for platinum and taxane agent skin testing in risk stratification of chemotherapy hypersensitivity. J Allergy Clin Immunol Pract. 2020 May;8(5):1665–67. 10.1016/j.jaip.2020.02.008
26. Vultaggio A, Matucci A, Nencini F, Bormioli S, Vivarelli E, Maggi E. Mechanisms of drug desensitization: Not only mast cells. Front Pharmacol. 2020 Dec 23;11:590991. 10.3389/fphar.2020.590991
27. Castells M. Rapid desensitization for hypersensitivity reactions to medications. Immunol Allergy Clin North Am. 2009 Aug;29(3):585–606. 10.1016/j.iac.2009.04.012.
28. Isabwe GAC, Garcia Neuer M, de Las Vecillas Sanchez L, Lynch DM, Marquis K, Castells M. Hypersensitivity reactions to therapeutic monoclonal antibodies: Phenotypes and endotypes. J Allergy Clin Immunol. 2018 Jul;142(1):159–170.e2. 10.1016/j.jaci.2018.02.018
29. Lopez-Gonzalez P, Madrigal-Burgaleta R, Carpio-Escalona LV, Bernal-Rubio L, Guerra E, Berges-Gimeno MP, et al. Assessment of antihistamines and corticosteroids as premedication in rapid drug desensitization to Paclitaxel: Outcomes in 155 procedures. J Allergy Clin Immunol Pract. 2018 Jul–Aug;6(4):1356–62. 10.1016/j.jaip.2017.11.013
30. Atanaskovic-Markovic M, Gomes E, Cernadas JR, du Toit G, Kidon M, Kuyucu S, et al. Diagnosis and management of drug-induced anaphylaxis in children: An EAACI position paper. Pediatr Allergy Immunol. 2019 May;30(3):269–76. 10.1111/pai.13034
31. Martelli A, Ippolito R, Votto M, De Filippo M, Brambilla I, Calvani M, et al. What is new in anaphylaxis? Acta Biomed. 2020 Sep 15;91(11-S):e2020005. 10.23750/abm.v91i11-S.10308
32. Lafay-Cousin L, Sung L, Carret AS, Hukin J, Wilson B, Johnston DL, et al. Carboplatin hypersensitivity reaction in pediatric patients with low-grade glioma: A Canadian Pediatric Brain Tumor Consortium experience. Cancer. 2008 Feb 15;112(4):892–9. 10.1002/cncr.23249
33. Akbayram S, Doğan M, Akgün C, Caksen H, Oner AF. A desensitization protocol in children with L-asparaginase hypersensitivity. J Pediatr Hematol Oncol. 2010 Jul;32(5):e187–91. 10.1097/MPH.0b013e3181e003c7
34. Chung CH, Mirakhur B, Chan E, Le QT, Berlin J, Morse M, et al. Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose. N Engl J Med. 2008 Mar 13;358(11):1109–17. 10.1056/NEJMoa074943
35. Hong DI, Bankova L, Cahill KN, Kyin T, Castells MC. Allergy to monoclonal antibodies: Cutting-edge desensitization methods for cutting-edge therapies. Expert Rev Clin Immunol. 2012 Jan;8(1):43–52; quiz 53–4. 10.1586/eci.11.75
36. Ensina LF, Aranda CS, de Lacerda AE, Camelo-Nunes I, Sole D, Martins AM, et al. Laronidase hypersensitivity and desensitization in type I mucopolysaccharidosis: A case report. Pediatr Allergy Immunol. 2014;25(5):498–9. 10.1111/pai.12209
37. Aranda CS, Ensina LF, Nunes IC, Mallozi MC, Mendes C, Martins AM, et al. Diagnosis and management of infusion-related hypersensitivity reactions to enzyme replacement therapy for lysosomal diseases: The role of desensitization. J Allergy Clin Immunol Pract. 2016;4(2):354–6. 10.1016/j.jaip.2015.11.012
38. Bekis Bozkurt H, Karakurt T, Cavkaytar O, Arga M. Shortened desensitization leading to a 2-year enzyme replacement therapy with elosulfase alfa. Ann Allergy Asthma Immunol. 2021;127(2):261–2.10.1016/j.anai.2021.04.040
39. Toh TSW, Chong KW, Goh AEN, Goh JCY, Ting TW, Tan ES, et al. Enzyme replacement therapy desensitization in a child with infantile onset Pompe disease. Asian Pac J Allergy Immunol. 2020. 10.12932/AP-060919-0638
40. Huffaker MF, Liu AY, Enns GM, Vijay S, Amor AJ, Adkinson NF Jr. Case series of sebelipase alfa hypersensitivity reactions and successful sebelipase alfa rapid desensitization. JIMD Rep. 2019;49(1):30–6. 10.1002/jmd2.12066
41. Capanoglu M, Dibek Misirlioglu E, Azkur D, Vezir E, Guvenir H, Gunduz M, et al. IgE-mediated hypersensitivity and desensitisation with recombinant enzymes in Pompe disease and Type I and Type VI mucopolysaccharidosis. Int Arch Allergy Immunol. 2016;169(3):198–202. 10.1159/000446154
42. Norton AE, Broyles AD. Management of children with hypersensitivity to antibiotics and monoclonal antibodies. Immunol Allergy Clin North Am. 2017;37(4):713–25. 10.1016/j.iac.2017.07.005
43. Jares EJ, Sánchez-Borges M, Cardona-Villa R, Ensina LF, Arias-Cruz A, Gómez M, et al. Multinational experience with hypersensitivity drug reactions in Latin America. Ann Allergy Asthma Immunol. 2014;113(3):282–9. 10.1016/j.anai.2014.06.019
44. Turvey SE, Cronin B, Arnold AD, Dioun AF. Antibiotic desensitization for the allergic patient: 5 Years of experience and practice. Ann Allergy Asthma Immunol. 2004;92(4):426–32. 10.1016/S1081-1206(10)61778-4
45. Legere HJ 3rd, Palis RI, Rodriguez Bouza T, Uluer AZ, Castells MC. A safe protocol for rapid desensitization in patients with cystic fibrosis and antibiotic hypersensitivity. J Cyst Fibros. 2009;8(6):418–24. 10.1016/j.jcf.2009.08.002
46. Palusci VJ, Kaul A, Lawrence RM, Haines KA, Kwittken PL. Rapid oral desensitization to trimethoprim-sulfamethoxazole in infants and children. Pediatr Infect Dis J. 1996;15(5):456–60. 10.1097/00006454-199605000-00015
47. Gómez-Traseira C, Boyano-Martínez T, Escosa-García L, Pedrosa M, Martín-Muñoz F, Quirce S. Trimethoprim–sulfamethoxazole (cotrimoxazole) desensitization in an HIV-infected 5-yr-old girl. Pediatr Allergy Immunol. 2015;26(3):287–9. 10.1111/pai.12353
48. Hasui M, Kotera F, Tsuji S, Yamamoto A, Taniuchi S, Fujikawa Y, et al. Successful resumption of trimethoprim–sulfamethoxazole after oral desensitisation in patients with chronic granulomatous disease. Eur J Pediatr. 2002;161(6):356–7. 10.1007/s00431-002-0944-6
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Mar 1, 2022
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Ensina, L. F., Rocha Felix, M. M., da Cunha, F. S., & Caubet, J.-C. (2022). Desensitization to drugs in children. Allergologia Et Immunopathologia, 50(2), 48-57. https://doi.org/10.15586/aei.v50i2.539
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Review Article
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How to Cite
Ensina, L. F., Rocha Felix, M. M., da Cunha, F. S., & Caubet, J.-C. (2022). Desensitization to drugs in children. Allergologia Et Immunopathologia, 50(2), 48-57. https://doi.org/10.15586/aei.v50i2.539