Allergic adverse reactions in children following tuberculosis chemotherapy

Abstract

Tolerability of anti-TB chemotherapy in children is an urgent problem. The study is devoted to the characteristics of adverse reactions (AR) of an allergic type (allergic and toxic-allergic) and the factors contributing to their occurrence. Materials and methods. The retrospective study included 146 children aged 0 to 14 years with respiratory TB who received TB chemotherapy, including 22 children with multidrug-resistant agent contact (MDR-TB). The spectrum of clinical and laboratory manifestations of АRs, frequency, risk factors were studied. Results. ARs with an allergic component were observed in 54 (37.0%) children, among them allergic in 32 (21.9%) and toxic-allergic in 22 (15.1%). The most common allergic reaction was asymptomatic eosinophilia (81.2%), in other cases, a combination of eosinophilia with dermatitis or only skin manifestations. A mild degree of eosinophilia prevailed, but in 3 patients it was severe (more than 20% of eosinophils in the leukogram). In toxic-allergic reactions, signs of allergy were combined with an increase in liver enzymes in 59.0% of children, less often with other disorders. It was found that the early age of children, complicated course of TB, MDR-TB regimen, hyperergic skin tests do not increase the chance of developing allergic ARs. A burdened allergic history increases the chance of allergic АR to anti-TB drugs 2.8 times, and the presence of a primary affect in the lung 3.1 times. Temporary discontinuation or replacement of drugs was required much more often in toxic-allergic reactions — 40.9% than in allergic ones — 18.7% (р <0.05). Allergic and toxic-allergic reactions were reversible. Conclusion. In the development of АRs to anti-TB drugs in children, the allergic factor is of significant importance. The creation of laboratory methods for diagnosing allergic reactions to anti-TB drugs would be useful.