Early Presentation With Angioedema and Urticaria in Cross-reactive Hypersensitivity to Nonsteroidal Antiinflammatory Drugs Among Young, Asian, Atopic Children

Objective. Nonsteroidal antiinflamma- tory drugs (NSAIDs), mainly ibuprofen, are used exten- sively among children as analgesic and antipyretic agents. Our initial survey in the Kendang Kerbau Chil- dren's Hospital in Singapore showed NSAIDs to be the second most common adverse drug reaction-causing medications among children of Asian descent. We at- tempted to characterize the clinical and epidemiologic profile of NSAID reactions in this group of patients. Methods. A retrospective case series from a hospital- based pediatric drug allergy clinic was studied. A diag- nosis of NSAID hypersensitivity was made with a mod- ified oral provocation test. Atopy was evaluated clinically and tested with a standard panel of skin-prick tests. We excluded from analysis patients with any un- provoked episodes of urticaria and/or angioedema, pa- tients