Allergy and intolerance to nonsteroidal antinflammatory drugs: successful desensitization in three cases
Keywords:
Drug hypersensitivity, aspirin, anti-inflammatory agents, non-steroidal, desensitization, immunologic, asthma, anaphylaxis, nasal polyps, sinusitis
Abstract
Adverse reactions to nonsteroidal antinflammatory drugs are the second cause of reactions to drugs after beta-lactams. Prevalence of these reactions among general population is between 0.1-0.3%, and prevalence of nonsteroidal antinflammatory drug-induced anaphylaxis is 0.01%.Acetylsalicylic acid or nonsteroidal antinflammatory drug sensitivity can be manifested as acute urticaria, angioedema, acute asthma, acetylsalicylic acid exacerbated respiratory disease and anaphylaxis.
An updated review based on three cases of patientes with acetylsalicylic acid or nonsteroidal antinflammatory drug intolerance is presented in which, because of their concomitant diseases, permanent treatment with acetylsalicylic acid was required. After undergoing a fast acetylsalicylic acid desentization protocol in an intensive care unit, these patients were able to receive daily acetylsalicylic acid doses without any adverse effects.
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References
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27. Zedlitz S, Linzbach L, Kaufmann R, Boehncke WH. Reproducible identification of the causative drug of a fixed drug eruption by oral provocation and lesional patch testing. Contact Derm. 2002;46:352-3.
28. Talhari C, Lauceviciute I, Enderlein E, Ruzicka T, Homey B. COX-2-selective inhibitor valdecoxib induces severe allergic skin reactions. J Allergy Clin Immunol. 2005;115:1089-90.
29. Pichler WJ, Tilch J. The lymphocyte transformation test in the diagnosis of drug hypersensitivity. Allergy. 2004;59:809-20.
30. Milewski M, Mastalerz L, Nizankowska E, Szczeklik A. Nasal provocation test with lysine-aspirin for diagnosis of aspirin-sensitive asthma. J Allergy Clin Immunol. 1998;101:581-6.
31. Nizankowska-Mogilnicka E, Bochenek G, Mastalerz L, Swierczynska M, Picado C, Scadding G, et al. EAACI/GA2LEN guideline: aspirin provocation tests for diagnosis of aspirin hypersensitivity. Allergy. 2007;62:1111-8.
2. Sánchez-Borges M. Clinical management of nonsteroidal anti-inflammatory drug hypersensitivity. WAO Journal. 2008;1:29-33.
3. Jenneck C, Juergens U, Buecheler M, Novak N. Pathogenesis, diagnosis, and treatment of aspirin intolerance. Ann Allergy Asthma Immunol. 2007;99:13-21.
4. Cianferoni A, Novembre E, Mugnaini L, Lombardi E, Bernardini R, Pucci N, et al. Clinical features of acute anaphylaxis in patients admitted to a university hospital: an 11-year retrospective review (1985-1996). Ann Allergy Asthma Immunol. 2001;87:27-32.
5. Szczeklik A, Stevenson DD. Aspirin-induced asthma: advances in pathogenesis, diagnosis, and management. J Allergy Clin Immunol. 2003;111:913-21.
6. Faich GA. Adverse-drug-reaction monitoring. N Engl J Med. 1986;314:1589-92.
7. Settipane GA. Aspirin and allergic diseases: a review. Am J Med. 1983;74:102-9.
8. Sánchez-Borges M, Capriles-Hulett A, Caballero-Fonseca F. NSAID-induced urticaria and angioedema: a reappraisal of its clinical management. Am J Clin Dermatol. 2002;3:599-607.
9. Castells M. Desensitization for drug allergy. Curr Opin Allergy Clin Immunol. 2006;6:476-81.
10. Berges-Gimeno MP, Simon RA, Stevenson DD. Long-term treatment with aspirin desensitization in asthmatic patients with aspirin-exacerbated respiratory disease. J Allergy Clin Immunol. 2003;111:180-6.
11. Gollapudi RR, Teirstein PS, Stevenson DD, Simon RA. Aspirin sensitivity: implications for patients with coronary artery disease. JAMA. 2004;292:3017-23.
12. Widal F, Abrami P, Lermoyez J. Anaphylaxie et idiosyncrasie. Presse Med. 1922;30:189-92.
13. Sweet JM, Stevenson DD, Simon RA, Mathison DA. Long-term effects of aspirin desensitization-treatment for aspirin-sensitive rhinosinusitis-asthma. J Allergy Clin Immunol. 1990;85:59-65.
14. Stevenson DD, Hankammer MA, Mathison DA, Christiansen SC, Simon RA. Aspirin desensitization treatment of aspirin-sensitive patients with rhinosinusitis-asthma: long-term outcomes. J Allergy Clin Immunol. 1996;98:751-8.
15. Pfaar O, Klimek L. Aspirin desensitization in aspirin intolerance: update on current standards and recent impro-vements. Curr Opin Allergy Clin Immunol. 2006;6:161-6.
16. White AA, Stevenson DD, Simon RA. The blocking effect of essential controller medications during aspirin challenges in patients with aspirin-exacerbated respiratory disease. Ann Allergy Asthma Immunol. 2005;95:330-5.
17. Stevenson DD, Simon RA. Selection of patients for aspirin desensitization treatment. J Allergy Clin Immunol. 2006;118:801-4.
18. Silberman S, Neukirch-Stoop C, Steg PG. Rapid desensitization procedure for patients with aspirin hypersensitivity undergoing coronary stenting. Am J Cardiol. 2005;95:509-10.
19. Sánchez-Borges M, Capriles-Hulett A, Caballero-Fonseca F. The multiple faces of nonsteroidal antiinflammatory drug hypersensitivity. J Investig Allergol Clin Immunol. 2004;14:329-34.
20. Stevenson DD. Aspirin and NSAID sensitivity. Immunol Allergy Clin North Am. 2004;24:491-505.
21. Johansson SG, Hourihane JO, Bousquet J, Bruijnzeel-Koomen C, Reborg S, Haahtela T, et al. A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force. Allergy. 2001;56:813-24.
22. Andri L, Senna G, Betteli C, Givanni S, Scaricabarozzi I, Mezzelani P, et al. Tolerability of nimesulide in aspirin-sensitive patients. Ann Allergy. 1994;72:29-32.
23. Kosnik M, Music E, Matjaz F, Suskovic S. Relative safety of meloxicam in NSAID-intolerant patients. Allergy. 1998;53:1231-3.
24. Nettis E, Di Paola R, Ferrannini A, Tursi A. Meloxicam in hypersensitivity to NSAIDs. Allergy. 2001;56:803-4.
25. Quiralte J, Blanco C, Castillo R, Delgado J, Carrillo T. Intolerance to nonsteroidal antiinflammatory drugs: results of controlled drug challenges in 98 patients. J Allergy Clin Immunol. 1996;98:678-85.
26. Ruxrungtham K, Chantaphakul H, Tiyasatapon S, Phanupak P. Acetaminophen cross-sensitivity is common in Thai patients with aspirin/NSAIDs Sensitivity and may be life-threatening. J Allergy Clin Immunol. 2002;109:s141.
27. Zedlitz S, Linzbach L, Kaufmann R, Boehncke WH. Reproducible identification of the causative drug of a fixed drug eruption by oral provocation and lesional patch testing. Contact Derm. 2002;46:352-3.
28. Talhari C, Lauceviciute I, Enderlein E, Ruzicka T, Homey B. COX-2-selective inhibitor valdecoxib induces severe allergic skin reactions. J Allergy Clin Immunol. 2005;115:1089-90.
29. Pichler WJ, Tilch J. The lymphocyte transformation test in the diagnosis of drug hypersensitivity. Allergy. 2004;59:809-20.
30. Milewski M, Mastalerz L, Nizankowska E, Szczeklik A. Nasal provocation test with lysine-aspirin for diagnosis of aspirin-sensitive asthma. J Allergy Clin Immunol. 1998;101:581-6.
31. Nizankowska-Mogilnicka E, Bochenek G, Mastalerz L, Swierczynska M, Picado C, Scadding G, et al. EAACI/GA2LEN guideline: aspirin provocation tests for diagnosis of aspirin hypersensitivity. Allergy. 2007;62:1111-8.
How to Cite
1.
Cardona R, Ramírez RH, Reina Z, Escobar MF, Morales E. Allergy and intolerance to nonsteroidal antinflammatory drugs: successful desensitization in three cases. biomedica [Internet]. 2009 Jun. 1 [cited 2024 May 17];29(2):181-90. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/20
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