Lorenz et al asked a series of questions to help determine if a drug was the probable cause for a histamine-release reaction. The authors are from the Universities of Marburg, Heidelberg and Munich in Germany.
Questions:
(1) Was the person actually exposed to the drug?
(2) Did the patient have allergic symptoms compatible with histamine effect?
(3) Did laboratory tests show an increase in histamine or other histamine release marker?
(4) Was exogenous histamine present as a contaminant?
(5) Was the patient administered another drug that can cause histamine release?
(6) Was the patient given a drug suspended in a solvent that is associated with histamine release?
Question
Drug Likely Cause
Subclinical Drug-Related Release
Drug-Related Clinical Reaction
1
Y
Y
Y
2
Y
N
Y
3
Y
Y
N
4
N
N
N
5
N
N
N
6
N
N
N
NOTE: In the implementation I added a question (Is there an alternative cause for an allergic reaction that could explain the clinical findings better?) to cover nonpharmacologic allergic reactions.
To read more or access our algorithms and calculators, please log in or register.
