{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:54:16Z","timestamp":1790834056722,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Local anesthetics (LAs) are widely utilized to provide analgesia in minor surgical interventions. Although patients are frequently referred for suspected LA allergies in clinical practice, confirmed cases of immediate\u2010type hypersensitivity remain rare. This study aims to establish an optimal diagnostic protocol for immediate\u2010type LA allergy in children and to assess the practicality and reliability of an alternative diagnostic approach for hypersensitivity testing of amide\u2010type local anesthetics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The medical records of patients diagnosed with suspected immediate\u2010type reactions to LAs administered by pediatric dentists between January 2019 and August 2024 were retrospectively reviewed. All children underwent a skin prick test (SPT), followed if negative by an intradermal test (IDT) at a 1:10 dilution. If intradermal testing was also negative, a subcutaneous provocation test was subsequently performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 88 patients (47 boys, 41 girls), with a mean age of 8.5\u2009\u00b1\u20093.5\u2009years, were included. In most cases (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200959, 67%), the suspected LA was unidentified. Among the known agents, articaine (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918, 20.5%) and lidocaine (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911, 12.5%) were the most frequently reported. IDT results were positive in 11 patients (12.5%), with articaine in 8 cases (61.5%), prilocaine in 3 cases (23%), and lidocaine in 2 cases (15.5%). Intradermal testing at a 1:10 dilution demonstrated a high negative predictive value (99%) for immediate\u2010type reactions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For the diagnosis of immediate\u2010type LA allergy, including cases with a history of anaphylaxis, an IDT at a 1:10 dilution following a negative SPT, followed by subcutaneous provocation, may serve as a time\u2010efficient and reliable diagnostic strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.70085","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T17:47:49Z","timestamp":1744048069000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of diagnostic tests for immediate\u2010type allergic reactions to amide group local anesthetics in children"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7052-3654","authenticated-orcid":false,"given":"Sinem","family":"Aslan","sequence":"first","affiliation":[{"name":"Department of Pediatric Allergy and Immunology Eskisehir Osmangazi University Faculty of Medicine  Eskisehir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0889-2491","authenticated-orcid":false,"given":"H\u00fclya","family":"An\u0131l","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology Eskisehir Osmangazi University Faculty of Medicine  Eskisehir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8099-6367","authenticated-orcid":false,"given":"Muhammet","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology Eskisehir Osmangazi University Faculty of Medicine  Eskisehir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8494-648X","authenticated-orcid":false,"given":"Koray","family":"Harmanc\u0131","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology Eskisehir Osmangazi University Faculty of Medicine  Eskisehir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/106002809603000724"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-022-08937-x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.allmed.2024.100009"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12833"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes162"},{"issue":"3","key":"e_1_2_10_7_1","first-page":"117","article-title":"Hypersensitivity to 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