ĐẶC ĐIỂM DỊ ỨNG VÀ KẾT QUẢ NHẬN DẠNG THUỐC CHỐNG LAO HÀNG 1 GÂY DỊ ỨNG TRÊN DA BẰNG TEST KÍCH THÍCH

Abstract

Background: Early detection of hypersensitivity reactions and appropriate management should be taken to optimize the treatment of tuberculosis. Objective: Description of hypersensitivity reactions from first-line antituberculosis drugs and results of drug provocation test at National Lung Hospital. Methods: Cross-sectional study of 86 pulmonary tuberculosis patients with signs and symtomps of hypersensitivity reactions, who were hospitalized and treated in the Department of Respiratory Tuberculosis at National Lung Hospital from August 2018 to June 2019. Excluded from the study were patients with anaphylaxis, severe allergy, SJS, Lyell syndrome, DRESS and who have uncontrolled obstructive airway (FEV1 <70%). Results: 48 ​​patients (55.8%) were detected urticaria, rash; 85 patients (98.8%) were detected pruritus. Cutaneous lesions: 55% at level 2, 39% at level 3 and 6% at level 4. Symptoms treatment before drugs provocation test: average duration of treatment is 4.3 days (1-16 days), 33,7% cases must be taken both antihistamines and corticosteroids. 81 patients were applied drugs provocation test with a total of 346 tests, of which 80 had a positive test. Prevalence of allergic drugs from high to low respectively: RIF, PZA, EMB, INH. 54 patients were allergic to only 1 drug, 13 patients were allergic to 2 drugs, nobody was  allergic to 3 drugs or more. Most patients had positive provocation test on the 2^nd or 3^rd day of protocol. Conclusion: The TB treatment regimen consists of a combination of drugs, so when an allergic reaction occurs it is very difficult to diagnose the drug that causes the reaction. However, when performing drug provocation test, it can identify correctly the cause of allergy.