{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:33:59Z","timestamp":1787312039145,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,7,30]],"date-time":"2017-07-30T00:00:00Z","timestamp":1501372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST103\u20102321\u2010B\u2010182A\u2010006"],"award-info":[{"award-number":["MOST103\u20102321\u2010B\u2010182A\u2010006"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST101\u20102628\u2010B\u2010182A\u2010001\u2010MY3"],"award-info":[{"award-number":["MOST101\u20102628\u2010B\u2010182A\u2010001\u2010MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST104\u20102314\u2010B\u2010182A\u2010148\u2010MY3"],"award-info":[{"award-number":["MOST104\u20102314\u2010B\u2010182A\u2010148\u2010MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Proton pump inhibitors (PPIs) have been known to induce type I hypersensitivity reactions. However, severe delayed\u2010type hypersensitivity reactions (DHR) induced by PPI, such as Stevens\u2010Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), or drug rash with eosinophilia and systemic symptoms (DRESS), are rarely reported. We conducted a study of a large series of PPI\u2010related DHR, followed up their tolerability to alternative anti\u2010ulcer agents, and investigated the T\u2010cell reactivity to PPI in PPI\u2010related DHR patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed patients with PPI\u2010related DHR from multiple medical centers in Taiwan during the study period January 2003 to April 2016. We analyzed the causative PPI, clinical manifestations, organ involvement, treatment, and complications. We also followed up the potential risk of cross\u2010hypersensitivity or tolerability to other PPI after their hypersensitivity episodes. Drug lymphocyte activation test (LAT) was conducted by measuring granulysin and interferon\u2010\u03b3 to confirm the causalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 69 cases of PPI\u2010related DHR, including SJS\/TEN (n=27) and DRESS (n=10). The LAT by measuring granulysin showed a sensitivity of 59.3% and specificity of 96.4%. Esomeprazole was the most commonly involved in PPI\u2010related DHR (51%). Thirteen patients allergic to one kind of PPI could tolerate other structurally different PPI without cross\u2010hypersensitivity reactions, whereas three patients developed cross\u2010hypersensitivity reactions to alternative structurally similar PPI. The cross\u2010reactivity to structurally similar PPI was also observed in LAT assay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PPIs have the potential to induce life\u2010threatening DHR. In patients when PPI is necessary for treatment, switching to structurally different alternatives should be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/all.13235","type":"journal-article","created":{"date-parts":[[2017,6,28]],"date-time":"2017-06-28T12:44:03Z","timestamp":1498653843000},"page":"221-229","source":"Crossref","is-referenced-by-count":52,"title":["Delayed\u2010type hypersensitivity reactions induced by proton pump inhibitors: A clinical and in vitro T\u2010cell reactivity study"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1619-6258","authenticated-orcid":false,"given":"C.\u2010y.","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Dermatology Chang Gung Memorial Hospital Linkou and Taipei Taiwan"},{"name":"Department of Dermatology Drug Hypersensitivity Clinical and Research Center Chang Gung Memorial Hospital Linkou Taiwan"},{"name":"College of Medicine Chang Gung University Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.\u2010W.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Dermatology Chang Gung Memorial Hospital Linkou and Taipei Taiwan"},{"name":"Department of Dermatology Drug Hypersensitivity Clinical and Research Center Chang Gung Memorial Hospital Linkou Taiwan"},{"name":"Chang Gung Immunology Consortium Chang Gung Memorial Hospital and Chang Gung University Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.\u2010Y. R.","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Dermatology Chang Gung Memorial Hospital Linkou and Taipei Taiwan"},{"name":"Department of Dermatology Drug Hypersensitivity Clinical and Research Center Chang Gung Memorial Hospital Linkou Taiwan"},{"name":"College of Medicine Chang Gung University Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.\u2010C.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Dermatology Chang Gung Memorial Hospital Linkou and Taipei Taiwan"},{"name":"Department of Dermatology Drug Hypersensitivity Clinical and Research Center Chang Gung Memorial Hospital Linkou Taiwan"},{"name":"College of Medicine Chang Gung University Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.\u2010H.","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Dermatology Chang Gung Memorial Hospital Linkou and Taipei Taiwan"},{"name":"Department of Dermatology Drug Hypersensitivity Clinical and Research Center Chang Gung Memorial Hospital Linkou Taiwan"},{"name":"College of Medicine Chang Gung University Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.\u2010Y.","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Administration Chang Gung Memorial Hospital Linkou Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.\u2010W.","family":"Chen","sequence":"additional","affiliation":[{"name":"Taiwan Drug Relief Foundation  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.\u2010M.","family":"Ke","sequence":"additional","affiliation":[{"name":"Taiwan Drug Relief Foundation  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.\u2010H.","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Dermatology Chang Gung Memorial Hospital Linkou and Taipei Taiwan"},{"name":"Department of Dermatology Drug Hypersensitivity Clinical and Research Center Chang Gung Memorial Hospital Linkou Taiwan"},{"name":"College of Medicine Chang Gung University Taoyuan Taiwan"},{"name":"Chang Gung Immunology Consortium Chang Gung Memorial Hospital and Chang Gung University Taiwan"},{"name":"Whole\u2010Genome Research Core Laboratory of Human Diseases Chang Gung Memorial Hospital Keelung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2013.08.022"},{"key":"e_1_2_10_3_1","first-page":"157","article-title":"Study of cross\u2010reactivity between proton pump inhibitors","volume":"20","author":"Sobrevia Elfau MT","year":"2010","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.7927"},{"key":"e_1_2_10_5_1","first-page":"203","article-title":"Anaphylactic reaction to drugs commonly used for gastrointestinal system diseases: 3 case reports and review of the literature","volume":"16","author":"Demirkan K","year":"2006","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199411103311906"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1990.01670250049006"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1993.01680220104023"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2007.02742.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.1884"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-7-200910060-00016"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2015.165"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000450952"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12189"},{"key":"e_1_2_10_15_1","first-page":"57","article-title":"Nine cases of omeprazole allergy: cross\u2010reactivity between proton pump inhibitors","volume":"19","author":"Lobera T","year":"2009","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_10_16_1","unstructured":"Maja Mockenhaupt.Update on severe cutaneous reactions from Register of SCAR (RegiSCAR). 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