I think the term pseudoallergen is outdated. It may have been appropriate 2 decades ago, but now that the non-allergic mechanism of several reaction types is know, the term is no longer appropriate. NSAIDs and ACE Inhibitors cause reactions by different mechanisms and should be listed as such, not under pseudoallergen.
3 Comments
Bruce Goldberg
Russ, I assume you are referring specifically to pseudoallergen and not pseudoallergy?
David Woods
Is the term drug hypersensitivity reaction more appropriate than drug allergy disorder or pseudoallergy ? More granular terms can be added as appropriate and/or when this information is defined or considered clinically important.
Bruce Goldberg
During today's meeting, we discussed that the term pseudoallergy may no longer be appropriate if we are defining pseudoallergy as more than just signs and symptoms resembling allergy but as a pathophysiologic mechanism as more specific mechanism types have been identified. It was suggested that pseudoallergy should be retired and replaced perhaps with Non-allergic hypersensitivity which is currently the term used by the WAO nomenclature. This will impact our proposed model as we are currently defining pseudoallergy in terms of a pathological process called pseudoallergic process. If we replace pseudoallergic process with non-allergic hypersensitivity process then it becomes difficult to articulate what a non-allergic hypersensitivity process is other than it is not an allergic process. This approach was not accepted for defining intolerance. The solution to this dilemma would be to create specific subclasses for the "pseudoallergic" conditions and processes by mechanism such as release of vasoactive mediators from basophils and mast cells and increased bradykinin. This is certainly a worthwhile endeavor imo. I will bring this topic up for discussion at a future events, conditions and episodes project group meeting.