Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs
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Cites background from "Classification and practical approa..."
...Proliferation of drug-specific T cells from patients with DHR upon the stimulation with the suspected drug(s) is measured by the incorporation of [3H] or carboxyfluorescein diacetate succinimidyl ester (CFSE) content using flow cytometry....
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...However, expert consensus has not been reached on the value of in vitro methods for DHR diagnosis....
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...Diagnosis of DHRs is primarily based on a detailed clinical history and in vivo procedures, such as skin testing (ST) and drug provocation tests (DPT)....
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...• For carbamazepine-induced DHR, the most powerful association has been established with HLA-B*15:02 and SJS/TEN in Han Chinese (119), Thai (120), Indian (121) and Malaysian (122) populations....
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...This means that in a large number of cases, DPT is the only test that can confirm the reaction (4, 9)....
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References
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...Grades of recommendations are defined according to the SIGN statement (2)....
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...Clinical presentation • Bronchial obstruction induced by aspirin/NSAIDs develops within 30–180 min after ingestion of the drug and may be accompanied by extrabronchial symptoms including nasal (rhinorrhea, nasal congestion), ocular, cutaneous (flushing of the upper thorax, urticaria and/or angioedema), or gastric symptoms (19)....
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757 citations
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...• There is no standardized protocol for drug provocation tests in delayed reactions to NSAIDs (86)....
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"Classification and practical approa..." refers background in this paper
...• T-cell-dependent mechanisms have been documented in delayed urticaria, MPE induced by aceclofenac and metamizol and in SCAR induced by ibuprofen (80, 81)....
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