Two approaches for diagnosis of nonsteroidal anti-inflammatory drug hypersensitivity in children
| Autor: | Isil Eser Simsek, Metin Aydogan, Mujde Tuba Cogurlu |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Drug medicine.medical_specialty Adolescent media_common.quotation_subject Immunology Culprit Drug Hypersensitivity 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Immunology and Allergy Medicine 030212 general & internal medicine Risk factor Child Skin Tests media_common Aspirin business.industry Medical record Anti-Inflammatory Agents Non-Steroidal Gold standard Infant Odds ratio digestive system diseases Confidence interval Hypersensitivity reaction Logistic Models 030228 respiratory system Child Preschool Multivariate Analysis Female business |
| Zdroj: | Annals of Allergy, Asthma & Immunology. 123:389-393 |
| ISSN: | 1081-1206 |
| DOI: | 10.1016/j.anai.2019.07.005 |
| Popis: | Background The oral provocation test (OPT) with culprit drug is the gold standard in the diagnosis of nonsteroidal anti-inflammatory drug hypersensitivity (NSAID-H). Some authors have proposed that the total number of OPTs required to diagnose NSAID-H is much lower with acetyl salicylic acid (ASA) provocations, regardless of patients' reaction history, and less time consuming. Objective This study aims to evaluate the total number of OPTs required to confirm NSAID-H according to the drugs (ASA or culprit NSAID) used in the initial OPT. Methods The study included patients with a history of NSAID-H. Data on the demographic and clinical features, coexisting chronic or allergic disease, and laboratory results were collected from medical records. The drug used for the initial OPT (ASA or culprit NSAID), results of the OPT, and the total number of OPTs were reviewed. Results We included 56 children with suspected hypersensitivity reaction to NSAIDs. NSAID-H was confirmed in 21 children (37.5%). We calculated that if all OPTs were performed with culprit drugs as an initial choice, the number of OPTs required for diagnosis would be 3 or more in 85.7% of positive cases. The number of episodes was an independent risk factor for NSAID-H by multiple logistic regression analysis (odds ratio, 4.3; 95% confidence interval, 1.48-12.24; P = .007). Conclusion Performing an initial OPT with ASA regardless of patients' reaction history can result in much lower numbers of OPT to diagnose NSAID-H and can improve patient compliance. |
| Databáze: | OpenAIRE |
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