Allergy Presentations

Allergy Presentations Overview

A presentation includes available information for a specific set of symptoms relating to an allergic reaction. By default, detailed information for presentations is turned off when returning allergy details, but you can turn them on by including the parameter include_presentation_details=true in your API query. Each presentation is tied to a particular condition, for example, "Anaphylaxis," which is linked to DBCOND0001820.

Every presentation entry is associated with one or more hypersensitivity types, as outlined in the allergy classification section. Additional fields provide simple and clinical descriptions of the allergic reaction and information regarding best practices for managing patients presenting with the condition.

Hypersensitivity Types

The hypersensitivity_types field for a presentation entry returns a list of hypersensitivity types, as explained in the allergy classification section. In the context of a presentation, the hypersensitivity type explains the underlying mechanism responsible for the observed symptoms.

Although most presentation entries have a single hypersensitivity type, it is possible to have multiple types listed for a single entry. There are several possible reasons for a presentation having more than one type:

1. The clinical presentation may occur via multiple unique mechanisms. For example, glomerulonephritis is typically caused by immune complex deposition (type III reaction) but is sometimes caused by circulating antibodies (type II reaction). As a result, both hypersensitivity types have been added to this presentation.
2. There are differences in classification of the hypersensitivity type for a particular presentation among sources. Therefore, we include several hypersensitivity types to ensure agreement with information available in the literature.

Simple Description

The simple_description field contains a short (2-3 sentence) paragraph describing the symptoms associated with the allergy presentation. Simple descriptions are written in simple terms without scientific language.

Clinical Description

The clinical_description field contains a longer (1-3 paragraph) explanation describing a presentation in more detail. Clinical descriptions vary between presentations depending on the associated symptoms, complexity of the underlying mechanism(s), and amount of information available in the literature. Clinical descriptions describe the associated symptoms using more scientifically and technically inclined language. If the underlying mechanism causing the symptoms is well understood, it is also described. Finally, if there is literature regarding laboratory results that point to a diagnosis, these are mentioned.

Management

The management field contains a relatively short (1-2 paragraph) description of general best practices for managing specific allergic presentations. Withdrawal of the causative drug is recommended in all cases; more detailed information is provided on a case-by-case basis. For example, in the case of "Stevens-Johnson Syndrome Toxic Epidermal Necrolysis Spectrum," the extensive skin detachment associated with the condition requires patient care in an ICU or burn ward, similar to burn victims.

Allergy Presentations Structure Overview

"presentations": [
  {
    "condition": {
      "drugbank_id": "DBCOND0001818",
"title": "Acute Generalized Exanthematous Pustulosis"
    },
    "hypersensitivity_types": [
      "Type IV"
    ],
    "simple_description": "Acute generalized exanthematous pustulosis (AGEP) is a rash with several small pimples or blisters that generally begin on the armpits and groin, and spread to cover the trunk and limbs. AGEP also causes an itching or burning sensation of the skin along with fever. In some cases, pimples or open sores develop in the mouth and other areas. This condition mainly occurs after taking a particular medication. [A204251,A204254]",
    "clinical_description": "Acute generalized exanthematous pustulosis (AGEP) is a condition characterized by pustules initially appearing on the groin and axillary regions, eventually progressing towards the trunk and extremities.  In many cases, AGEP occurs as a result of a drug reaction. The onset is typically 2-11 days following exposure to the offending drug; it is identified by pustules on an area of edematous erythema. Pustule confluence can result in Nikolsky's sign, with superficial skin detachment occurring in early-stage, and possibly late-stage pustular desquamation. In 20-25% of cases, lesions and erosions develop on mucous membranes, especially on the oral mucosa.[A204251,A204254]\n\nCases of systemic inflammation with AGEP are associated with fever, leukocytosis (\u003e10,000/mL), and neutrophilia (\u003e7000/mL). In some cases, eosinophilia and hypocalcemia are detected. Histological examination usually reveals intraepidermal pustules with or without papillary edema, in addition to necrotic keratinocytes, mild vasculitis, and infiltrate containing eosinophils and neutrophils.[A204251,A204254]\n",
    "management": "Withdrawal of the offending drug is sometimes sufficient in self-limiting cases of AGEP. Desquamation can be managed via the administration of topical or systemic corticosteroids, disinfectants, and lotions. Systemic symptoms such as fever may be treated with antipyretics or other systemic therapies. Antibiotic use is not recommended in AGEP.[A204251,A204254] Supportive care measures are the cornerstones of management and should be tailored to each individual's clinical presentation. When choosing an alternative agent, consider cross-sensitivity and avoid agents that are structurally related, if possible.[A201914,A204257]"
  }...
]