Long‐term absence of sensitization to mepivacaine as assessed by a diagnostic protocol including patch testing

@article{Astarita2001LongtermAO,
  title={Long‐term absence of sensitization to mepivacaine as assessed by a diagnostic protocol including patch testing},
  author={Corrado Astarita and Domenico Gargano and C. Romano and Marina Cutajar and Francesco Manguso and D. Montanaro and A Napolitano and F. Pezzuto and M. Lo Schiavo and Paolo Altucci and Gabriella Abbate},
  journal={Clinical \& Experimental Allergy},
  year={2001},
  volume={31}
}
Background Prospective assessment of non‐reactivity to local anaesthetics is a frequent reason for allergy consultation. 
Immediate‐ and delayed‐type allergic reactions to amide local anesthetics: clinical features and skin testing
TLDR
The aim of this study was to describe the main characteristics of ADRs induced by amide type local anesthetic drugs.
Hypersensitivity to local anaesthetics
TLDR
Although skin test is useful in the diagnosis, a negative result should be cautiously interpreted when the reaction had not occurred recently, as in the case of LAAG, which turned positive after the challenge test.
Hypersensitivity to local anaesthetics – update and proposal of evaluation algorithm
TLDR
This review attempts to generate a comprehensive update on allergic reactions to LA and to present an algorithm that can be used for the evaluation of patients suspected with immediate‐ and delayed‐type immune reactions.
Identification of Risk Factors and Cross-Reactivity of Local Anesthetics Hypersensitivity: Analysis of 14-Years’ Experience
TLDR
Only patients with an LA-induced ADR should be referred to an allergy clinic and history of generalized cutaneous symptoms and/or hypotension during the reaction may define subjects with an increased risk of LA allergy.
Approach to Patients With Suspected Hypersensitivity to Local Anesthetics
TLDR
Several confounding variables involved in the evaluation, including the roles of preservatives/additives, epinephrine, latex, and inadequate testing procedures are identified, which may cause significant diagnostic challenges for clinicians.
IgE-mediated allergy to local anaesthetics: separating fact from perception: a UK perspective.
TLDR
Evidence from this review confirms the rarity of IgE-mediated allergy to LA and supports an investigation strategy based on using the clinical history to select patients for skin testing and challenge, and believes that such a triage process would alleviate pressures on allergy services without compromising patient safety.
HYPERSENSITIVITY TO LOCAL ANAESTHETICS - 6 FACTS AND 7 MYTHS
TLDR
A review of the literature has shown that true allergy to LA is in fact exceptional, and Provocation challenge is safe and well tolerated.
Allergy to Local Anesthetics is a Rarity: Review of Diagnostics and Strategies for Clinical Management
TLDR
Local anesthetics (LA) are commonly used in procedures and in topical agents for pain management and reactions are a result of hypersensitivity to other culprits such as preservatives, excipients, or other exposures.
Evaluation of adverse reactions to local anesthetics: experience with 236 patients.
Anaphylactic reactions to local anesthetics.
TLDR
Practical management of patients with a history of LA reaction includes a careful allergy history, skin-prick and intradermal tests, and a regimen of 'reverse placebo provocation' with injection of a LA (verum) is applied in a placebo-controlled manner.
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References

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Bisulfite sensitivity manifesting as allergy to local dental anesthesia.
Evaluation of Patients with History of Allergy to Local Anesthetic Drugs
The author believe that most of the so-called allergic reactions to these drugs are merely a cutaneouos sensitivity and not anaphylactoid. They review the methods used in their study to reach a
Evaluation of patients with history of allergy to local anesthetic drugs.
The author believe that most of the so-called allergic reactions to these drugs are merely a cutaneouos sensitivity and not anaphylactoid. They review the methods used in their study to reach a
Contribution to the problem of allergy to local anesthetics.
Type IV allergy to amide‐type local anesthetics
TLDR
The case of a 45‐year‐old woman, who developed intense erythema and itching 1 day after subcutaneous injection of a local anesthetic containing mepivacaine and methylparben, showed sensitization to lidocaine, a compound to which she had previously also been exposed.
Local anesthetic intolerance due to metabisulfite
The case of a 40‐year‐old woman with severe edema of the face and neck after the injection of a local dental anesthetic is presented. The reaction is attributed to the presence of sodium
pDelayed‐type hypersensitivity to subcutaneous lidocaine with tolerance to articaine: confirmation by in vivo and in vitro tests
TLDR
Intradermal patch and lymphocyte transformation tests revealed sensitization to lidocaine and cross‐reactivity to the other aminoacylamide local anesthetics bupivacaine, but not to articaine.
Contact sensitivity to the amide anesthetics lidocaine, prilocaine, and mepivacaine. Case report and review of the literature.
TLDR
Multiple sensitivities to amide local anesthetics occurred in a 70-year-old woman following dental treatment, and patch testing confirmed type IV hypersensitivity to lidocane, prilocaine, mepivacaine, and dibucaine.
Long‐term evaluation of usefulness of skin and incremental challenge tests in patients with history of adverse reaction to local anesthetics
TLDR
Evaluation protocols are effective in selecting an agent susceptible to tolerance, but are time consuming, however, they probably contribute to an important reassurance effect that is likely to increase tolerance to subsequent local anesthetic administration.
Adverse Responses to Local Anaesthetics
TLDR
Progressive challenge was used to investigate patients with a history of an adverse response to local anaesthesia and true allergy was detected in only one patient, and preservative-free local anaesthetic preparations should be used for subsequent anaesthesia.
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