Wednesday, September 04, 2013

Not sure about PPI hypersensitivity? You should do this.

Researchers in the August issue of European Journal of Allergy and Clinical Immunology for the first time assessed the role of skin testing in the diagnosis of Proton Pump Inhibitor (PPI)-related immediate hypersensitivity reactions and the cross-reactivity patterns among PPIs.

Standardized skin prick and intradermal tests were carried out with a panel of PPIs. The suspected PPIs were lansoprazole, esomeprazole, pantoprazole, rabeprazole, and omeprazole. The sensitivity, specificity, and negative and positive predictive values of the skin tests with PPIs were 58.8%, 100%, 70.8%, and 100%, respectively. Half of the patients with a hypersensitivity reaction to lansoprazole had a positive oral provocation result or skin test result with at least one of the alternative PPIs.


Considering the high specificity, skin testing seems to be a useful method for the diagnosis of immediate-type hypersensitivity reactions to PPIs and for the evaluation of cross-reactivity among PPIs. However, oral provocation tests should be performed in case of negativity on skin tests.


Bonnie: Reactions to PPIs are very common and this is something that could conceivably be performed at a doctor's office.

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