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Drug Hypersensitivity
Edited by Werner J Pichler. Published by S
Karger AG, Basel, Switzerland, 2007. ISBN 9783805582698. Contains 438 pages.
Price CHF 274
This is one of the first texts on the subject of drug
hypersensitivity that covers such an extensive range of topics. Other textbooks
on the subject focus on a single or limited number of areas or are specific to a
particular organ of involvement or drug class. The book therefore has broad
appeal with interest to those practising and/or researching in allergy, clinical
immunology, dermatology, pharmacology, HIV medicine, microbiology, haematology,
anaesthetics, nephrology, or hepatology.
The book is organised into 5 sections comprised of 33
consistently structured chapters that contain useful tables, figures, coloured
photos, and up-to-date references.
The second section (12 chapters) examines the
pathomechanisms, genetics and animal models of drug hypersensitivity. The
initial 5 chapters focus on immunopathogenesis. Both well established mechanisms
such as haptenisation and novel theories such as the “p-i or
pharmacological interaction with immune
receptors” are discussed. A chapter is devoted to the exciting area of
pharamocogenetics with emphasis on the strong influence of genetic
susceptibility to SJS in Han Chinese in relation to allopurinol and
carbamazepine use. One chapter deals with the adverse side effects to biological
agents, which are being exponentially developed and increasingly used in
clinical practice. There are three chapters that each describes hypersensitivity
to an antiretroviral drug, which may have been better condensed to a single
chapter. Another chapter advocates for better animal models in drug development
that predict for and thereby reduces the risk of SCAR.
The third section (13 chapters) dedicates chapters to
various generalised and organ-specific hypersensitivity diseases with an
informative initial chapter on the current classification, causes and
manifestations of various drug hypersensitivity reactions. A proportion of
chapters are drug-specific (betalactam antibiotics, non-betalactam antibiotics,
contrast media, and aspirin/NSAIDS). Other more specific topics include
perioperative anaphylaxis and paediatric drug and vaccine allergy. These
clinical chapters are detailed and comprehensive and do not provide information
in a bulleted or boxed format for clinicians seeking swift and succinct
direction.
The fourth section (2 chapters) is dedicated to in
vivo and in vitro diagnosis and the fifth section (2 chapters) on
desensitisation to antibiotics, chemotherapy agents and monoclonal antibodies.
These sections do provide concise advice and protocols for physicians. However,
the section on desensitisation should have been broadened to include protocols
on cephalosporins, sulphonamides, aspirin and insulin.
I can recommend this textbook as a very useful reference for
the clinician, pharmacologist, epidemiologist and researcher. The editor and
authors have successfully negotiated the challenging task of describing and
crystallising the protean and nebulous aspects entailed in the dynamic field of
drug hypersensitivity.
Suran Fernando
Staff Specialist, Clinical Immunology and Allergy Royal North Shore Hospital, Sydney, Australia |
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