Destaques do I Workshop de Alergia a Medicamentos em Crianças
Highlights from the I Workshop on Drug Allergy in Children
Mara Morelo Rocha Felix; Luis Felipe Chiaverini Ensina; Gladys Reis e Silva de Queiroz; Maria Inês Perelló; Cristiane de Jesus Nunes dos Santos; Carolina Sanchez Aranda
Resumo
Em novembro de 2015 foi realizado o I Workshop de Alergia a Medicamentos em Crianças no Brasil. Este encontro científico foi organizado pelo Grupo de Assessoria em Alergia a Medicamentos da Associação Brasileira de Alergia e Imunologia (ASBAI), com o objetivo de discutir os aspectos mais relevantes e peculiares das reações de hipersensibilidade a medicamentos (RHM) em crianças. A hipersensibilidade a drogas em crianças é pouco conhecida. Muitos algoritmos utilizados em adultos são replicados em crianças, sem pesquisas específicas nesta faixa etária. As crianças com suspeita de RHM devem ser avaliadas através da história clínica que irá orientar quanto à necessidade da realização de exames complementares (testes in vivo e in vitro). As infecções podem atuar como cofatores ou como diagnósticos diferenciais. Existem protocolos desenvolvidos especificamente para essa faixa etária. Um exemplo é a investigação dos exantemas benignos não imediatos associados ao uso de beta-lactâmicos (BLs). Nesses casos, o teste de provocação oral (TPO) é uma ferramenta fundamental para o diagnóstico. Na hipersensibilidade aos anti-inflamatórios não esteroidais (AINEs), o TPO também pode auxiliar no diagnóstico e na busca de uma alternativa segura. A abordagem dos pacientes com reações vacinais constitui outra importante área da alergia pediátrica. Nesses casos, o conhecimento da relação risco vs. benefício pode evitar exclusões desnecessárias. O presente artigo foi elaborado a partir das discussões ocorridas durante o Workshop. Seu objetivo é apresentar os principais pontos ressaltados nas aulas e fazer algumas recomendações relacionadas à hipersensibilidade a medicamentos na faixa etária pediátrica.
Palavras-chave
Abstract
In November 2015, the I Workshop on Drug Allergy in Children (I Workshop de Alergia a Medicamentos em Crianças) was held in Brazil. This scientific meeting was organized by the Advisory Group on Drug Allergy of the Brazilian Association of Allergy and Immunology (Associação Brasileira de Alergia e Imunologia, ASBAI) with the goal of discussing the most relevant and unique aspects of drug hypersensitivity reactions (DHR) in children. Knowledge of drug hypersensitivity in children is limited. Many algorithms used in adults are replicated in children without specific research in this age group. Children with suspected DHR should be evaluated for their clinical history, which will reveal the need for complementary tests (in vivo and in vitro). Infections may act as cofactors or as differential diagnoses. There are protocols developed specifically for this age group. One example is the investigation of non-immediate benign skin rashes associated with the use of beta-lactam antibiotics (BLs). In these cases, oral provocation tests (OPT) are important tools or diagnosis. In cases of hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs), OPT can also assist in the diagnosis and search for a safe treatment option. The management of patients with vaccine reactions is another important field in pediatric allergy. In these cases, knowledge of the risk-benefit ratio may avoid unnecessary exclusion recommnedations. This article was prepared based on discussions taking place at the workshop. The aim was to present the highlights of the sessions and provide recommendations on how to manage DHR in the pediatric population.
Keywords
References
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Submitted date:
05/10/2016
Accepted date:
10/16/2016
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