HYPERSENSITIVITY TO antituberculosis DRUGS IN PATIENTS with PULMONARY TUBERCULOSIS

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HYPERSENSITIVITY TO antituberculosis DRUGS IN PATIENTS with PULMONARY TUBERCULOSIS

Journal Title: Астма и Аллергия - Year 2018, Vol 1, Issue 2

Abstract

The objective of our work was to highlight the actual problem of practical phthisiology around the world - the manifestations of hypersensitivity to anti-tuberculosis drugs in patients with pulmonary tuberculosis, their classification, origin, methods of diagnosis and treatment. The article gives a literary review of the modern view of the problem, possible ways of its solution, some modern laboratory methods of study of hypersensitivity to drugs. To date, the main classification of adverse reactions to drugs used by most professionals around the world, involves the division of their mechanism of development into 4 types. The frequency of adverse reactions to tuberculosis chemotherapy varies widely from 16.9% to 97.0%. In the treatment of TB medicines of the reserve series undesirable side-effects are found in 72.8% of the examined patients. In the spectrum of adverse reactions are hepatotoxic (59.3%), allergic (53.6%), gastrointestinal (35.6%), hyperurinemia (61.6%). Most immune-mediated undesirable reactions to drugs have skin reactions and many patients are accompanied by systemic disorders. Anti-TB drugs can provoke the development of all four types of allergic hypersensitivity reactions, but most often on chemotherapy there is a mixed variant of allergy. Taking into account the limited number of drugs for treatment of tuberculosis and the specific mode of the appointment of polychemotherapy, timely diagnosis and treatment of adverse allergic reactions remain unresolved. It is their correction, especially in the early stages, with the use of different pathogenetic means, to prevent and eliminate side effects of anti-TB drugs and thereby provide an optimal treatment for the underlying disease. Most of the tests used to diagnose the causes of an allergic reaction in the treatment of patients with tuberculosis are clinical, which are associated with diagnostic measures with the direct involvement of the patient, which is associated with risks to his health. Among the modern in vitro methods for diagnosis of medical allergy in large centers of the most developed countries of the West, commercial tests are used to determine specific IgE to medications, cellular allergen stimulation tests, cytotoxic tests, lymphocyte transformation reaction, basophil activation test, histamine release test - but the number of subjects studied allergens in them are limited, and anti-TB drugs are not foreseen. In Ukraine, as in other countries, there are no standardized and standardized laboratory methods for diagnosis of hypersensitivity to anti-TB drugs. Proceeding from the collected material, timely diagnosis of the causes of allergic reaction, standardization of laboratory methods for diagnosis of hypersensitivity, the search for ways to improve chemotherapy of tuberculosis, manifestations of adverse skin reactions and systemic changes in the treatment of this ailment remain an actual problem of practical medicine. Key words: pulmonary tuberculosis, hypersensitivity, anti-tuberculosis drugs, laboratory diagnostic methods.

Authors and Affiliations

Y. A. Matvienko, O. R. Panasiukova

Keywords

pulmonary tuberculosis hypersensitivity anti-tuberculosis drugs laboratory diagnostic methods.

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EP ID EP395575
DOI 10.31655/2307-3373-2018-2-12-19
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