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Provocation tests with the offending nonsteroidal anti-inflammatory drugs in patients with urticaria/angioedema reactions
- Source :
- Allergy and Asthma Proceedings. 33:421-426
- Publication Year :
- 2012
- Publisher :
- Oceanside Publications Inc., 2012.
-
Abstract
- The provocation test (PT) with the suspected drug represents the gold standard in the diagnosis of non-IgE hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs). Nevertheless, there is no consensus regarding the clinical management of suspected NSAID-sensitive patients. This study assessed if a PT with the suspected drug is a reliable and safe proceeding to confirm NSAID hypersensitivity in patients with a clinical history of urticaria/angioedema (Urt/AE). It also analyzed different patient characteristics (such as gender, age, atopy, dermographism, time interval between the last drug reaction, and number of previous NSAID reactions) in relation to PT positivity. One hundred fifty-nine patients with Urt/AE apparently related to assumption of one or more NSAIDs underwent PT with the suspected drugs. Moreover, to distinguish single/multiple NSAID reactivity in patients who did not tolerate the offending NSAID, another strong cyclooxygenase-1 inhibitor PT was performed. PT was negative in 142/159 patients (89.31%), ruling out a diagnosis of NSAIDs hypersensitivity; 17/159 patients (10.69%) experienced a reaction of Urt/AE during the PT: 8 patients were diagnosed as single reactors to NSAIDs and 4 as multiple reactors to NSAIDs. Those with a history of multiple NSAID reactions and male patients were both more likely to have a positive PT. Our results suggest that in all patients with history of NSAID cutaneous reactions, the NSAID hypersensitivity should be confirmed by an oral PT and that the diagnostic proceeding can safely start with the offending NSAID.
- Subjects :
- Adult
Hypersensitivity, Immediate
Male
musculoskeletal diseases
Pulmonary and Respiratory Medicine
Drug
medicine.medical_specialty
Adolescent
Urticaria
medicine.drug_class
media_common.quotation_subject
Provocation test
Administration, Oral
digestive system
Anti-inflammatory
Drug Hypersensitivity
Atopy
Young Adult
chemistry.chemical_compound
medicine
Humans
Immunology and Allergy
In patient
Angioedema
Child
skin and connective tissue diseases
media_common
Nonsteroidal
business.industry
Anti-Inflammatory Agents, Non-Steroidal
Angioneurotic oedema
General Medicine
Middle Aged
medicine.disease
Dermatology
digestive system diseases
chemistry
Child, Preschool
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 10885412
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Allergy and Asthma Proceedings
- Accession number :
- edsair.doi.dedup.....e659952184d915927be838953a4c9b0c