Table 3. Utilization of in vitro tests for severe DHRs in our clinical practice.
| Immediate DHR | ||||||
| DHRs manifestation | Possible culprits | In vitro-tested drugs | BAT | STs | DPT | |
| Anaphylaxis | Lidocaine | Lidocaine | Negative | Negative | ND | |
| Mepivacaine | Negative | Negative | Negative | |||
| Final drug use: Mepivacaine | ||||||
| Anaphylaxis | Iobitridol | Iobitridol | Negative | ND | ND | |
| Iopromide | Negative | ND | Negative | |||
| Iohexol | Negative | ND | ND | |||
| Ioxagate | Negative | ND | ND | |||
| Final drug use: Iopromide (no premed, no ADR) | ||||||
| Possible Kounis syndrome | Amoxicillin/clavulanic | Amoxicillin | Negative | Negative | ND | |
| Clavulanic | Negative | Negative | ND | |||
| Continue to avoid amoxicillin/clavulanic | ||||||
| Delayed-type DHR | ||||||
| DHRs manifestation | Possible culprits | In vitro-tested drugs | LTT | STs | DPT | |
| DRESS | IRZE | Isoniazid (I) | Negative | ND | Negative | |
| Rifampicin (R) | Positive | ND | ND | |||
| Ethambutol (E) | Negative | ND | Negative | |||
| Pyrazinamide (Z) | Positive | ND | ND | |||
| Levofloxacin (L) | Negative | ND | Negative | |||
| Final regimen: IEL | ||||||
| DRESS | IRZE | Isoniazid (I) | Negative | ND | Negative | |
| Rifampicin (R) | Negative | ND | Negative | |||
| Ethambutol (E) | Negative | ND | Negative | |||
| Pyrazinamide (Z) | Positive | ND | ND | |||
| Levofloxacin (L) | Positive | ND | ND | |||
| Final regimen: IRE | ||||||
DHR, drug hypersensitivity reaction; BAT, basophil activation test; ST, skin test; DPT, drug provocation test; ND, not determined; ADR, adverse drug reaction; DRESS, drug reaction with eosinophilia and systemic symptoms; LTT, lymphocyte transformation test; IRZE, isoniazid, rifampicin, pyrazinamide, ethambutol.