exudates and Drug-Hypersensitivity

Co-trimoxazole, a sulfonamide antibiotic, is used to treat a variety of infections worldwide, and it remains a common first-line medicine for prophylaxis against Pneumocystis jiroveci pneumonia. However, it can cause severe cutaneous adverse reaction (SCAR), including Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms. The pathomechanism of co-trimoxazole-induced SCAR remains unclear.. We aimed to investigate the genetic predisposition of co-trimoxazole-induced SCAR.. We conducted a multicountry case-control association study that included 151 patients with of co-trimoxazole-induced SCAR and 4631 population controls from Taiwan, Thailand, and Malaysia, as well as 138 tolerant controls from Taiwan. Whole-genome sequencing was performed for the patients and population controls from Taiwan; it further validated the results from Thailand and Malaysia.. The whole-genome sequencing study (43 case patients vs 507 controls) discovered that the single-nucleotide polymorphism rs41554616, which is located between the HLA-B and MICA loci, had the strongest association with co-trimoxazole-induced SCAR (P = 8.2 × 10. This study identified HLA-B∗13:01 as an important genetic factor associated with co-trimoxazole-induced SCAR in Asians.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Anti-Infective Agents, Urinary; Asian People; Case-Control Studies; Drug Hypersensitivity; Female; Genetic Predisposition to Disease; HLA-B Antigens; Humans; Malaysia; Male; Middle Aged; Polymorphism, Single Nucleotide; Taiwan; Thailand; Trimethoprim, Sulfamethoxazole Drug Combination; Whole Genome Sequencing; Young Adult

Topics: Antibody Specificity; Antivenins; Bandages; Blood Coagulation; Blood Transfusion; Drug Hypersensitivity; Epinephrine; Fear; First Aid; Hemoglobinuria; Humans; Malaysia; New Guinea; Pain; Placebos; Respiratory Insufficiency; Snake Bites; Tracheotomy; United States

Recent years, the prevalence of paracetamol allergy becomes great concerns. However, data on knowledge, attitude and perception towards allergic reactions of paracetamol are lacking. This study aimed to investigate knowledge, attitude, and perception towards allergic reactions of paracetamol (KAP-ARP). A cross-sectional survey was conducted using a validated self-administered questionnaire around Pasar Siti Khadijah, Kelantan from February 2016 to January 2017 among the general population. A total of 177 respondents participated in this study. The mean percentage scores for knowledge, attitude and perception towards allergic reactions of paracetamol were 31.7% (SD 23.6), 53.1% (SD 19.2) and 53.3% (SD 23.9), respectively. This study revealed that respondents demonstrated a poor level of knowledge, a fair level of attitude and negative perception towards allergic reactions of paracetamol. These results may lay a basis for conducting a study of knowledge, attitude and perception towards allergic reactions among general population in other different setting or around Malaysia.

Topics: Acetaminophen; Adolescent; Adult; Analgesics, Non-Narcotic; Cross-Sectional Studies; Drug Hypersensitivity; Female; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Male; Middle Aged; Risk Assessment; Risk Factors; Surveys and Questionnaires; Young Adult

Topics: Drug Hypersensitivity; Hospitals, Public; Humans; Inappropriate Prescribing; Malaysia; Medical Records; Medication Errors

To report 2 cases of hypersensitivity reactions associated with oxaliplatin treatment in Asian patients.. A 33-year-old Chinese woman received adjuvant oxaliplatin in combination with fluorouracil and leucovorin. Shortly during her sixth infusion, she developed a severe hypersensitivity reaction. Despite prophylactic measures, she developed another reaction of similar severity during her subsequent infusion and was not further rechallenged with oxaliplatin. The second case involved a 45-year-old Malay woman who received oxaliplatin, fluorouracil, and leucovorin for metastatic colorectal cancer. Shortly during her ninth infusion, she developed a mild hypersensitivity reaction. With prophylactic measures, she developed less marked reactions with her subsequent 3 infusions.. Hypersensitivity reactions to oxaliplatin have been reported to be between 12% and 16% in the Western population. As of April 20, 2005, there are only 2 previously published reports of hypersensitivity reactions to oxaliplatin in 6 Asian patients. The incidence rates of such reactions in different Asian ethnic groups could vary. The cumulative dose, time of exposure to oxaliplatin, and clinical features were variable and unpredictable in all of the reported Asian patients who developed hypersensitivity reactions. An objective causality assessment using the Naranjo probability scale revealed that oxaliplatin was the highly probable cause of hypersensitivity in the 2 Asian patients reported by our center.. Patients who develop mild to moderate reactions can be rechallenged with the drug administered as a slow infusion with prophylactic measures. Desensitization may allow patients who experience severe hypersensitivity reactions to oxaliplatin to further receive effective therapy for their colorectal cancer.

Topics: Adult; Anti-Allergic Agents; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; China; Chlorpheniramine; Colorectal Neoplasms; Drug Hypersensitivity; Female; Fluorouracil; Humans; Hydrocortisone; Infusions, Intravenous; Leucovorin; Malaysia; Organoplatinum Compounds; Oxaliplatin; Pregnancy; Treatment Outcome

Topics: Adult; AIDS-Related Opportunistic Infections; Anti-Infective Agents; China; Drug Eruptions; Drug Hypersensitivity; Female; HIV Infections; Humans; Malaysia; Male; Middle Aged; Pneumonia, Pneumocystis; Retrospective Studies; Scotland; Trimethoprim, Sulfamethoxazole Drug Combination; White People

Health care workers have been reported to constitute one of the few high-risk groups related to IgE-mediated hypersensitivity associated with the use of latex products. This paper describes the first ever study of prevalence carried out in Malaysia among these workers. One hundred and thirty health care personnel from Hospital Kuala Lumpur were skin tested. Extracts used were prepared from seven different brands of natural rubber latex gloves with varying levels of extractable protein (EPRRIM). Out of the 130 volunteers, 4 (3.1%) had positive skin test to latex with extracts with high levels of EPRRIM (> 0.7 mg/g). The prevalence among the Malaysian health care workers can be considered to be low in comparison to that of some consumer countries as the USA which reported a prevalence of as high as 16.9%.

Topics: Adult; Drug Hypersensitivity; Female; Health Personnel; Humans; Latex; Malaysia; Male; Occupational Diseases; Prevalence

Topics: Adolescent; Dapsone; Dermatitis Herpetiformis; Drug Hypersensitivity; Female; Humans; Leprosy; Malaysia; Male; Middle Aged

Topics: Adult; Aging; Ampicillin; Anaphylaxis; Anemia, Hemolytic; Anemia, Sickle Cell; Drug Eruptions; Drug Hypersensitivity; Epinephrine; Humans; Malaysia; Male; Nephritis, Interstitial; Penicillins; Skin Tests

Topics: Adolescent; Adult; Aged; Child; Drug Hypersensitivity; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Length of Stay; Malaysia; Male; Middle Aged; Poisoning; Prospective Studies; Self Medication

Topics: Adult; Aged; Antigen-Antibody Reactions; Drug Hypersensitivity; Ethnicity; Female; Health Surveys; Histoplasmin; Histoplasmosis; Humans; Hypersensitivity, Delayed; Malaysia; Male; Mass Screening; Middle Aged; Mycobacterium Infections; Skin Tests; Tuberculin Test