2024
Diagnosis and Clinical Management of Drug Allergies in Obstetrics and Gynecology: An Expert Review
Burn M, Kwah J, Son M. Diagnosis and Clinical Management of Drug Allergies in Obstetrics and Gynecology: An Expert Review. American Journal Of Obstetrics And Gynecology 2024 PMID: 39490659, DOI: 10.1016/j.ajog.2024.10.025.Peer-Reviewed Original ResearchPenicillin allergyAntibiotic allergyAllergy evaluationDrug allergySkin testOral challengePregnant patientsObstetrician-gynecologistsAntibiotic useAssociated with increased cesarean deliveryAllergy testingGroup B streptococcus sepsisPatient historyNeonatal length of stayManagement of drug allergyIncreased length of hospital stayUnverified penicillin allergyLength of hospital stayFirst-line therapyFirst line antibioticsInduction of drug toleranceHigh-risk patientsSurgical site infectionIncreased surgical site infectionAdministration of antibioticsThe Cost of Developing and Implementing an Antepartum Referral Program for Penicillin Allergy Evaluation at a Single Academic Tertiary Care Hospital
Burn M, Xu X, Kwah J, Liao J, Son M. The Cost of Developing and Implementing an Antepartum Referral Program for Penicillin Allergy Evaluation at a Single Academic Tertiary Care Hospital. American Journal Of Perinatology 2024, 41: 1290-1297. PMID: 38423122, DOI: 10.1055/a-2278-9279.Peer-Reviewed Original ResearchCost of careReferral programLong-term cost benefitsPenicillin allergyAntibiotic costsAntibiotic stewardshipPregnant individualsProgram developmentAcademic tertiary care hospitalCompare costs of carePenicillin allergy evaluationShort-term costsTertiary care hospitalDelivery hospitalizationsResource utilization dataNo significant differenceNonreferred patientsCare hospitalUtilization dataAllergy evaluationBivariate testsStudy groupEducational initiativesPregnancy periodProgram costsValidating PEN-FAST in Reported Penicillin Allergies in Pregnancy to Enhance De-Labeling
You L, Liao J, Su C, Burn M, Son M, Kwah J. Validating PEN-FAST in Reported Penicillin Allergies in Pregnancy to Enhance De-Labeling. Journal Of Allergy And Clinical Immunology 2024, 153: ab155. DOI: 10.1016/j.jaci.2023.11.510.Peer-Reviewed Original ResearchPerioperative Hypersensitivity Evaluation: Too-Often Overlooked but Effective at Promoting the Safe Passage of Future Procedures
Liao J, Belmont A, Kwah J. Perioperative Hypersensitivity Evaluation: Too-Often Overlooked but Effective at Promoting the Safe Passage of Future Procedures. Journal Of Allergy And Clinical Immunology 2024, 153: ab167. DOI: 10.1016/j.jaci.2023.11.544.Peer-Reviewed Original Research
2023
DIAGNOSING THE UNCOMMON: BULLOUS PEMPHIGOID PRESENTING AS ECZEMATOUS DERMATITIS AND SEVERE PRURITIS
You L, Kwah J, Cohen J, Wong K. DIAGNOSING THE UNCOMMON: BULLOUS PEMPHIGOID PRESENTING AS ECZEMATOUS DERMATITIS AND SEVERE PRURITIS. Annals Of Allergy Asthma & Immunology 2023, 131: s189-s190. DOI: 10.1016/j.anai.2023.08.584.Peer-Reviewed Original ResearchAtopic dermatitisBullous pemphigoidSevere pruritusVariable clinical presentationSkin lesionsEczematous dermatitisCases of BPMonths of therapyHistory of asthmaSubset of patientsElevated IgG antibodiesSevere pruritisTense bullaeTopical corticosteroidsAllergic rhinitisPersistent pruritusAppropriate patientsInitial presentationScaly rashClinical presentationRare entityFinal diagnosisIgG antibodiesRare conditionCommon conditionEvaluating the PEN-FAST Clinical Decision-making Tool to Enhance Penicillin Allergy Delabeling
Su C, Belmont A, Liao J, Kuster J, Trubiano J, Kwah J. Evaluating the PEN-FAST Clinical Decision-making Tool to Enhance Penicillin Allergy Delabeling. JAMA Internal Medicine 2023, 183: 883-885. PMID: 37338869, PMCID: PMC10282954, DOI: 10.1001/jamainternmed.2023.1572.Peer-Reviewed Original ResearchDrug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms. Part II diagnosis and management
Wei B, Fox L, Kaffenberger B, Korman A, Micheletti R, Mostaghimi A, Noe M, Rosenbach M, Shinkai K, Kwah J, Phillips E, Bolognia J, Damsky W, Nelson C. Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms. Part II diagnosis and management. Journal Of The American Academy Of Dermatology 2023, 90: 911-926. PMID: 37516356, DOI: 10.1016/j.jaad.2023.02.073.Peer-Reviewed Original ResearchSevere cutaneous adverse reactionsCutaneous adverse reactionsSystemic symptomsDrug reactionsAdverse reactionsDifferential diagnosisDrug-induced hypersensitivity syndrome/drug reactionDrug-induced hypersensitivity syndromeDiHS/DRESSVisceral organ involvementSteroid-sparing agentCornerstone of managementFirst-line therapyEvidence-based overviewSystemic corticosteroidsHypersensitivity syndromeImmediate discontinuationOrgan involvementRisk stratificationAutoimmune diseasesAdjunctive testNeoplastic disordersDiagnostic criteriaLongitudinal evaluationDiagnosisDrug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms. Part I. Epidemiology, pathogenesis, clinicopathological features, and prognosis
Wei B, Fox L, Kaffenberger B, Korman A, Micheletti R, Mostaghimi A, Noe M, Rosenbach M, Shinkai K, Kwah J, Phillips E, Bolognia J, Damsky W, Nelson C. Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms. Part I. Epidemiology, pathogenesis, clinicopathological features, and prognosis. Journal Of The American Academy Of Dermatology 2023, 90: 885-908. PMID: 37516359, DOI: 10.1016/j.jaad.2023.02.072.Peer-Reviewed Original ResearchSevere cutaneous adverse reactionsDiHS/DRESSClinicopathological featuresSystemic symptomsDrug reactionsDrug-induced hypersensitivity syndrome/drug reactionDrug-induced hypersensitivity syndromePart I. EpidemiologyVisceral organ involvementCutaneous adverse reactionsRisk of relapseHypersensitivity syndromeOrgan involvementI. EpidemiologyOrgan dysfunctionSignificant morbidityAutoimmune diseasesAdverse reactionsDrug exposureT cellsCommon triggerImmune systemPathogenesisEosinophiliaMedical education activitiesPregnant Patients with a Documented History of Penicillin Allergy and Associated Maternal and Neonatal Outcomes at a Tertiary Care Center
Azmy V, Lundsberg L, Culhane J, Kwah J, Partridge C, Son M. Pregnant Patients with a Documented History of Penicillin Allergy and Associated Maternal and Neonatal Outcomes at a Tertiary Care Center. American Journal Of Perinatology 2023, 41: e2051-e2057. PMID: 37211008, DOI: 10.1055/a-2096-5002.Peer-Reviewed Original ResearchPenicillin allergy historyNon-β-lactam antibioticsPenicillin allergyNeonatal outcomesPregnant patientsAllergy historyPregnant individualsElectronic medical recordsMedical recordsMultivariable analysisPostpartum endometritisHigh riskLactam antibioticsSignificant differencesBad obstetric outcomeRetrospective cohort studyTertiary care centerPostnatal hospital stayWeeks of gestationLarge academic hospitalAssociated maternalEligible deliveriesHospital stayMaternal outcomesObstetric outcomesA safe, effective, and single-day protocol for rapid drug desensitization to intravenous iron dextran
Belmont A, Liao J, Hsu F, Kwah J. A safe, effective, and single-day protocol for rapid drug desensitization to intravenous iron dextran. The Journal Of Allergy And Clinical Immunology In Practice 2023, 11: 3242-3244.e1. PMID: 37329952, DOI: 10.1016/j.jaip.2023.06.018.Peer-Reviewed Original ResearchAntibiotic choice for Group B Streptococcus prophylaxis in mothers with reported penicillin allergy and associated newborn outcomes
Snider J, Mithal L, Kwah J, Rhodes N, Son M. Antibiotic choice for Group B Streptococcus prophylaxis in mothers with reported penicillin allergy and associated newborn outcomes. BMC Pregnancy And Childbirth 2023, 23: 400. PMID: 37254067, PMCID: PMC10228028, DOI: 10.1186/s12884-023-05697-0.Peer-Reviewed Original ResearchConceptsGroup B streptococcus prophylaxisReported penicillin allergyPenicillin allergyGBS prophylaxisLab drawsNeonatal outcomesNewborn outcomesAntibiotic administrationMedical recordsPregnant individualsIntrapartum group B streptococcus prophylaxisNeonatal intensive care unit admissionDesignThis retrospective cohort studyIntensive care unit admissionSelf-reported penicillin allergyNeonates of mothersCare unit admissionIntrapartum antibiotic prophylaxisRetrospective cohort studyWeeks of gestationMother-infant pairsMother-infant dyadsBeta-lactam antibioticsAntibiotic prophylaxisUnit admissionCephalosporins can be safely administered to patients with verified penicillin allergy
Belmont A, Su C, Kwah J. Cephalosporins can be safely administered to patients with verified penicillin allergy. The Journal Of Allergy And Clinical Immunology In Practice 2023, 11: 2933-2935.e2. PMID: 37245737, DOI: 10.1016/j.jaip.2023.05.027.Peer-Reviewed Original ResearchDelayed Intradermal Skin Testing to Diagnose Culprits Drugs in Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS)
Kwah J, Banerji A. Delayed Intradermal Skin Testing to Diagnose Culprits Drugs in Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS). The Journal Of Allergy And Clinical Immunology In Practice 2023, 11: 1572-1573. PMID: 37150547, DOI: 10.1016/j.jaip.2023.02.013.Peer-Reviewed Case Reports and Technical Notes
2022
Clinical Phenotypes of Immediate First-Dose Reactions to mRNA COVID-19: A Multicenter Latent Class Analysis
Stone CA, Robinson LB, Li L, Krantz MS, Kwah JH, Ortega G, Mancini C, Wolfson AR, Saff RR, Samarakoon U, Hong DI, Koo G, Chow TG, Gruchalla R, Liao JX, Kuster JK, Price C, Ahola C, Khan DA, Phillips EJ, Banerji A, Blumenthal KG. Clinical Phenotypes of Immediate First-Dose Reactions to mRNA COVID-19: A Multicenter Latent Class Analysis. The Journal Of Allergy And Clinical Immunology In Practice 2022, 11: 458-465.e1. PMID: 36108922, PMCID: PMC9468049, DOI: 10.1016/j.jaip.2022.08.048.Peer-Reviewed Original ResearchConceptsMRNA COVID-19 vaccineNovel clinical phenotypesCOVID-19 vaccineDose 1Second doseClinical phenotypeObjective signsLatent class analysisMRNA coronavirus disease 2019 (COVID-19) vaccinesDose toleranceAllergy/immunology specialistsMRNA COVID-19 vaccinationCoronavirus disease 2019 (COVID-19) vaccinesSelf-limiting symptomsFirst-dose reactionsU.S. academic medical centersLog-binomial regressionCOVID-19 vaccinationDistinct clinical phenotypesAcademic medical centerImmediate reactionsImmunology specialistsClass analysisAllergic symptomsRetrospective studySurvey of Obstetric Providers to Assess the Knowledge and Management of a Reported Penicillin Allergy in Pregnant Women
Cate JJM, Burn M, Kwah J, Liao J, Illuzzi J, Reddy U, Son M. Survey of Obstetric Providers to Assess the Knowledge and Management of a Reported Penicillin Allergy in Pregnant Women. American Journal Of Perinatology 2022, 40: 001-008. PMID: 35709740, DOI: 10.1055/a-1877-9970.Peer-Reviewed Original ResearchConceptsPenicillin skin testingReported penicillin allergyPenicillin allergyObstetric providersPractice patternsEducational sessionsAllergy knowledgeProvider knowledgeEducational interventionSingle academic medical centerPenicillin allergy delabelingPenicillin allergy evaluationPenicillin allergy testingPercentage of patientsIdentification of patientsClinical practice patternsSmall group educational sessionsAcademic medical centerChi-square testAllergy evaluationPenicillin allergicPerinatal outcomesPregnant patientsDrug allergyAllergy testingDefining Clinical and Immunological Predictors of Poor Immune Responses to COVID-19 mRNA Vaccines in Patients with Primary Antibody Deficiency
Shin JJ, Par-Young J, Unlu S, McNamara A, Park HJ, Shin MS, Gee RJ, Doyle H, Afinogenova Y, Zidan E, Kwah J, Russo A, Mamula M, Hsu FI, Catanzaro J, Racke M, Bucala R, Wilen C, Kang I. Defining Clinical and Immunological Predictors of Poor Immune Responses to COVID-19 mRNA Vaccines in Patients with Primary Antibody Deficiency. Journal Of Clinical Immunology 2022, 42: 1137-1150. PMID: 35713752, PMCID: PMC9203263, DOI: 10.1007/s10875-022-01296-4.Peer-Reviewed Original ResearchMeSH KeywordsAntibodies, ViralCD8-Positive T-LymphocytesCommon Variable ImmunodeficiencyCOVID-19COVID-19 VaccinesHumansImmunity, CellularImmunoglobulin AImmunoglobulin GMRNA VaccinesPrimary Immunodeficiency DiseasesRNA, MessengerSARS-CoV-2Spike Glycoprotein, CoronavirusVaccinationVaccinesVaccines, SyntheticConceptsCommon variable immune deficiencyT cellsImmune responseIgG responsesCVID patientsMRNA vaccinesB cellsCoronavirus disease 2019 (COVID-19) mRNA vaccinesCOVID-19 mRNA vaccinesBaseline immune profileHistory of autoimmunityPrimary antibody deficiencyT cell responsesCellular immune responsesPoor immune responseVariable immune deficiencyMemory B cellsSARS-CoV-2 spike proteinBaseline IgGCVID diagnosisEM CD8Immunological predictorsPAD cohortSpecific CD4Immune profileOutpatient penicillin allergy evaluation during pregnancy and associated clinical outcomes
Kwah JH, Burn MS, Liao J, Cate J, Son M. Outpatient penicillin allergy evaluation during pregnancy and associated clinical outcomes. American Journal Of Obstetrics & Gynecology MFM 2022, 4: 100674. PMID: 35691578, DOI: 10.1016/j.ajogmf.2022.100674.Peer-Reviewed Original ResearchConceptsPenicillin allergy evaluationPenicillin allergyPregnant womenAllergy evaluationHospital stayNeonatal outcomesClinical benefitIntensive care unit admissionBirth hospitalization lengthUnverified penicillin allergyCare unit admissionNeonatal adverse outcomesRetrospective cohort studyMedical record reviewPostpartum hospital stayAdditional clinical benefitLarge academic hospitalElectronic medical recordsBeta-lactam antibioticsPostpartum infectionReferred womenUnit admissionMaternal outcomesCohort studyTrue allergyEducational Intervention to Improve Skin Test Utilization in Low-Risk Penicillin Allergy
Kuster J, Kwah J. Educational Intervention to Improve Skin Test Utilization in Low-Risk Penicillin Allergy. Journal Of Allergy And Clinical Immunology 2022, 149: ab77. DOI: 10.1016/j.jaci.2021.12.280.Peer-Reviewed Original Research
2021
Safety Evaluation of the Second Dose of Messenger RNA COVID-19 Vaccines in Patients With Immediate Reactions to the First Dose
Krantz MS, Kwah JH, Stone CA, Phillips EJ, Ortega G, Banerji A, Blumenthal KG. Safety Evaluation of the Second Dose of Messenger RNA COVID-19 Vaccines in Patients With Immediate Reactions to the First Dose. JAMA Internal Medicine 2021, 181: 1530-1533. PMID: 34309623, PMCID: PMC8314170, DOI: 10.1001/jamainternmed.2021.3779.Peer-Reviewed Original Research
2020
Clinical factors associated with acute exacerbations of chronic rhinosinusitis
Kwah JH, Somani SN, Stevens WW, Kern RC, Smith SS, Welch KC, Conley DB, Tan BK, Grammer LC, Yang A, Schleimer RP, Peters AT. Clinical factors associated with acute exacerbations of chronic rhinosinusitis. Journal Of Allergy And Clinical Immunology 2020, 145: 1598-1605. PMID: 32004523, PMCID: PMC8177481, DOI: 10.1016/j.jaci.2020.01.023.Peer-Reviewed Original ResearchConceptsFrequent acute exacerbationsChronic rhinosinusitisAcute exacerbationAllergic rhinitisClinical factorsEosinophil countAutoimmune diseasesSignificant health care burdenSinus disease severityRetrospective cohort studySystemic corticosteroid useHealth care burdenHigh-risk phenotypeAntibiotic allergyExacerbation frequencyFrequent exacerbationsSinus symptomsCorticosteroid useCohort studyLower FEVNasal polyposisAntibody deficiencyImpaired qualityImmunologic diseasesOdds ratio