A South African multidisciplinary drug hypersensitivity clinic

Immune function is not limited to a particular organ system and neither is immune-mediated pathology. Drug hypersensitivity reactions, having a diversity of pathophysiologic mechanisms, manifest with a range of clinical disorders. A particular drug can cause varied immune-based pathology in different individuals and to varying extents in the context of co-morbid diseases such as HIV. Consequently, a range of specialists care for the different reactions caused by a single drug. This may limit our ability to detect common clinical features and uncover unifying immunopathogenesis linked by the pharmacology of the particular offending drug. Furthermore, in South Africa with the ongoing TB/HIV epidemics, drug hypersensitivity reactions are common, occur in the context of polypharmacy and concomitant systems pathology and frequently require multidisciplinary input for optimal care within the constraints of limited therapeutic alternatives. To address this problem and in line with the global trend towards systems biology and personalised medicine, a multidisciplinary drug hypersensitivity clinic at Groote Schuur Hospital has recently been started - the first of its kind in South Africa. This article outlines the background to the formation of this initiative, the potential advantages and needs of a multidisciplinary drug hypersensitivity clinic and the focal starting point of this clinic to better understand the spectrum of immune-based hypersensitivity reactions to Rifampicin.