DRUG PROVOCATION TEST AS A DIAGNOSTIC APPROACH FOR HYPERSENSITIVITY REACTION TO ANTITUBERCULOSIS DRUGS: A REPORT OF TWO CASES

KETUT SURYANA

doi:10.22159/ajpcr.2020.v13i5.37248

Authors

KETUT SURYANA Department of Internal Medicine, Merpati Clinic HIV, Allergy-Clinical Immunology Services Unit, Wangaya Hospital, Denpasar, Bali, Indonesia.

DOI:

https://doi.org/10.22159/ajpcr.2020.v13i5.37248

Keywords:

Antituberculosis drug, Drug hypersensitivity reaction, Drug provocation test, Rapid desensitization

Abstract

Pulmonary tuberculosis (PTB) continues to be a public health problem, especially in developing countries. The necessity use of multidrug regimens of antituberculosis drug (ATD) in PTB treatment has been associated with increased risk of drug hypersensitivity reactions (DHRs). DHR is a type of unpredictable reaction, refers to immunologically mediated hypersensitivity reactions. It is observed more frequently in the intensive phase of the PTB treatment with varying degrees of severity. DHR can lead to reduce the patient adherence, thereby leading to stoppage of the drugs by the patient. The definite diagnosis based on drug provocation test (DPT) that should be performed at a hospital. The recommended therapeutic approach is rapid desensitization by reintroducing drugs in safety and optimal under threshold dose until usual daily dose is reached. We present two cases of DHR to ATD, DPT as the diagnosis and rapid desensitization as the therapeutic approach.

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