Immediate reactions to proton pump inhibitors: Clinical findings and testing outcomes
Main Article Content
Keywords
anaphylaxis, cross-reactivity, immediate hypersensitivity, lansoprazole, proton pump inhibitor
Abstract
Background: Proton pump inhibitors (PPIs) are identified to cause immediate hypersensitivity reactions and cross-reactivity among them. In this study, we aimed to describe the clinical features of immediate-type hypersensitivity reactions caused by PPIs, the results of drug tests performed with PPIs, and the cross-reactivity between PPIs. There are immediate hypersensitivity reactions with PPIs and there may be cross-reactivity between PPIs. In this study, we aimed to describe the clinical features of immediate-type hypersensitivity reactions caused by PPIs, the results of drug tests performed with PPIs and the cross-reactivity between PPIs.
Methods: Adult patients who described an immediate hypersensitivity reaction to PPIs between March 1, 2017 and March 1, 2023 were evaluated.
Results: Of the 47 patients included in the study, 89.4% were females, and the suspected PPI in 68% of the patients was lansoprazole. Anaphylaxis accounted for 72.3% of reactions, and the most common reaction was grade 2 (42.6%) according to Ring Messmer. Those who had two or more reactions to the same or different PPI were 51.1% of patients. A positivity rate of 43.8% was observed in the skin prick test with the suspected drug, 33.3% in the intradermal test, and 100% in the provocation test. There is varying potential for cross-reactivity among five different PPIs.
Conclusions: İmmediate hypersensitivity reactions are observed among PPIs, particularly to lansoprazole, with the majority of reactions being anaphylaxis. Multiple life-threatening reactions can be prevented by increasing awareness of allergies to PPIs. Cross-reactivities among PPIs are variable, and further studies are needed to elucidate cross-reactivity with PPIs.
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