Hypersensitivity Reactions to Nonsteroidal Anti-Inflammatory Drugs among Adults: Clinical Features and Risk Factors for Diagnosis Confirmation
| Autor: | Ângela Gaspar, Daniela Malheiro, Eva Rebelo Gomes, Luísa Geraldes, Eugénia Almeida, Marta Chambel, Carmo Abreu, Emília Faria, Susana Cadinha |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male 0301 basic medicine Drug Time Factors Adolescent medicine.drug_class media_common.quotation_subject Immunology Drug allergy MEDLINE Cross Reactions Anti-inflammatory Drug Hypersensitivity Young Adult 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Risk Factors Clinical investigation Humans Immunology and Allergy Medicine Young adult Aged Skin Tests media_common Nonsteroidal business.industry Anti-Inflammatory Agents Non-Steroidal General Medicine Middle Aged medicine.disease Phenotype 030104 developmental biology 030228 respiratory system chemistry Female business |
| Zdroj: | International Archives of Allergy and Immunology. 171:269-275 |
| ISSN: | 1423-0097 1018-2438 |
| DOI: | 10.1159/000452627 |
| Popis: | Background: Nonsteroidal anti-inflammatory drugs (NSAIDS) are among the most common causes of drug hypersensitivity (HS) reactions. The diagnosis is based on a careful clinical history, and provocation tests are considered the gold standard for diagnosis. Skin tests have some value to study reactions to pyrazolones. Laboratory investigations are mostly used for research purposes. Different phenotypes have been described. Objective and Methods: Our aim was to describe the most common clinical manifestations of NSAID HS in a large population of adult patients, the drugs involved, the association with previously described risk factors, and the outcome of diagnostic procedures. The classification of reactions proposed by the European Academy of Allergy and Clinical Immunology (EAACI) Drug Allergy Interest Group was adopted. Results: Acetylsalicylic acid was the drug most often involved in reactions (34%), isolated cutaneous symptoms were the most reported (60%), and immediate reactions (58%) were the most common. There was an overall female predominance (64%) and 35% of the patients were atopic. HS to NSAIDs was confirmed in 21% of the patients. The most common phenotypes encountered among HS patients were NSAID-induced urticaria/angioedema and single-NSAID-induced urticaria/angioedema or anaphylaxis. Logistic regression analysis showed that gender and atopy were not significant risk factors for HS confirmation, but diagnosis depended on the number of previous reactions, the type of reaction, and the time interval between drug intake and reaction. Conclusion: Only 21% of suspected HS reactions were confirmed after diagnostic workup. Patients describing >1 previous reaction and suffering immediate reactions had a higher probability of a positive investigation. |
| Databáze: | OpenAIRE |
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