Armentia A, et al. – A research was formulated to gauge the clinical value of allergy tests (prick, IgE, challenges, and arrays) in people suffering hypersensitivity reactions (asthma and anaphylaxis) during local anesthesia with cocaine derivatives and drug abusers with allergic symptoms after cocaine inhalation. In this study, cocaine appeared as an important allergen. Results reported risk in drug abusers and patients sensitized to local anesthesia and tobacco. Sensitization to cocaine was determined by both prick tests and specific IgE against coca leaf extract. Moreover, the highest levels were related to severe clinical profiles.

Methods

• Cocaine-dependent patients and allergic patients who suffered severe reactions during local anesthesia from a database of 23,873 patients, were selected.
• Taking a positive challenge as the criterion standard, the diagnostic yield (sensitivity, specificity, and predictive value) of allergy tests using cocaine and coca leaf extracts in determining cocaine allergy was assessed.

Results

• 41 of 211 patients (19.4%) were diagnosed as sensitized to cocaine, after prick tests, specific IgE, and challenge with cocaine extract.
• For the diagnosis of cocaine allergy and LA-derived allergy, prick tests and IgE to coca leaves (coca tea) had a good sensitivity (95.1% and 92.7%, respectively) and specificity (92.3 and 98.8%, respectively).