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. 2023 Jun 30;13(13):2241.
doi: 10.3390/diagnostics13132241.

Diagnostic Evaluation of Hypersensitivity Reactions to Antibiotics in a Large Cohort of Mastocytosis Patients

Jesper Jarkvist  1 , Theo Gülen  1   2   3   4
Affiliations

Diagnostic Evaluation of Hypersensitivity Reactions to Antibiotics in a Large Cohort of Mastocytosis Patients

Jesper Jarkvist et al. Diagnostics (Basel). .

Abstract

Background: Anaphylactic reactions are a well-known feature of mastocytosis, particularly in relation to hymenoptera venom stings. Although data on the frequency of drug hypersensitivity reactions is limited in mastocytosis, it is hypothesized that these patients may be predisposed to hypersensitivity reactions to certain drugs, including antibiotics. Nevertheless, this issue has not been systematically investigated. Thus, we investigate the prevalence and clinical features of hypersensitivity reactions to antibiotics (HRA) in mastocytosis.

Methods: A 15-year retrospective study was conducted among 239 (≥18 years old) consecutive mastocytosis patients who were investigated in our center. All patients underwent a thorough allergy work-up, where self-reported reactions were individually evaluated by an allergist.

Results: Overall, 34 patients (14.2%) were deemed to have HRA. Most patients reacted with cutaneous symptoms (74%), and anaphylaxis was rare, confirmed only in two of 34 patients (0.8%). Beta-lactams were the most common elicitors (63%). There were no differences in age, gender, atopic status and tryptase levels between mastocytosis patients with and without antibiotic hypersensitivity.

Conclusions: The present study indicates a similar prevalence of HRA in mastocytosis compared to those of the general population. Moreover, antibiotics appear to be rare elicitors of anaphylaxis in these patients. Hence, our results suggest that mastocytosis patients without a history of HRA may be treated with these drugs without special precautions.

Keywords: KIT D816V; anaphylaxis; antibiotics; atopy; beta-lactams; drug allergy; hypersensitivity; mastocytosis; prevalence; tryptase.

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Conflict of interest statement

The authors declare that they have no conflict of interest related to this study.

Figures

Figure 1
Figure 1
Flow-chart of the patient selection process.
Figure 2
Figure 2
Clinical features of drug hypersensitivity reactions to antibiotics in mastocytosis patients: (A)—Involved organ systems during reactions. Of note, multiple organ systems may be involved in certain reactions. Abbreviations: GI, gastrointestinal; RESP, respiratory; CARDV, cardiovascular. (B)—Characteristics of cutaneous reactions. Notably, multiple skin-symptoms may be present during a single reaction.
Figure 3
Figure 3
Distribution of culprit antibiotics eliciting drug hypersensitivity reactions (n = 38).
See this image and copyright information in PMC

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