IS IT ATOPY A RISK FACTOR FOR DRUG ALLERGY?

Jenny Badas, Fabricia Carolino, Eunice Castro, Josefina Cernadas

Servio de Imunoalergologia, Centro Hospitalar So Joo E.P.E., Porto, Portugal

Background: A possible association between atopy and drug allergy has been
previously postulated, particularly with certain groups such as nonsteroidal anti-
inflammatory drugs. However, few studies have addressed this concept.
Aim: To investigate the association of atopy with drug allergy.
Methods: We conducted a review of the medical records of all patients that were
studied in the Drug Allergy Unit during 2014 (n=230), We have focussed in this study
on the questionnaire related to history of hypersensitive reactions to drugs and the
prick-test for common aeroallergens in orther to evaluate the presence of atopy.
Patients that did not perform skin prick tests with aeroallergens were excluded (n=66).
Data were analysed using IBM SPSS Statistics.
Results: We included 164 patients (72.6% females) with a meanSD age of 39.122.0
years (range 4-85 years). Hypersensitivity reactions had predominantly a delayed onset
(n=82, 50%) and skin involvement was the most frequent presentation (n=141, 86.5%).
The diagnosis was established based on the anamnesis (n=21, 12.8%), positive skin
tests (n=28, 56.5%), or positive drug challenge (n=20, 43.5%). Drug allergy was
confirmed in 46 (28.0%) patients and the main culprit group were antibiotics (n=20,
43.5%) with beta-lactams as the most involved (n=15; 75%). Skin prick tests with
aeroallergens were positive in 63 (38.4%) of all patients; the most frequent sensitizing
allergens were house dust and storage mites (n=53, 32.3%) and grass pollen (n=32,
19.5%). There was personal history of asthma and/or rhinitis in 89% of atopic patients
(n=60). of whom 43% had asthma (n=27). Drug allergic patients were similar to those
without drug allergy regarding sex distribution (females - 73.9% vs. 72.0%, p=0.81) but
regarding the meanSD age we found a significant statistical difference (47.119.5 vs.
35.922.2, p=0.003); concerning atopic status, no significant differences were
observed between the two groups of patients evaluated (34.8% of drug allergic
patients vs. 39.8% of non-allergic patients (p=0.55).

Conclusions: With the present study, we could demonstrate that atopy, defined by
positive prick-test to aeroallergens , was not correlated with a confirmed drug allergy
diagnosis. We could not found atopy as risk factor for drug allergy. More studies are
needed to clarify this association.