Hypersensitivity reactions to nonsteroidal anti-inflammatory drugs in adults: Beyond current classification
Allergol. immunopatol
; 51(5)01 sept. 2023. tab
Article
em En
| IBECS
| ID: ibc-225051
Biblioteca responsável:
ES1.1
Localização: ES15.1 - BNCS
ABSTRACT
Background: Hypersensitivity reactions (HSRs) to nonsteroidal anti-inflammatory drugs (NSAIDs) are a significant clinical issue. Several classifications have been proposed to categorize these reactions, including the current European Academy of Allergy and Clinical Immunology/European Network for Drug Allergy (EAACI/ENDA) classification. This study aimed to evaluate the applicability of this classification in a real-world clinical setting. Methods: We conducted a national multicenter study involving patients from nine hospitals in four major urban centers in Turkey. All patients had a suggestive clinical history of hypersensitivity reactions to NSAIDs. Researchers collected data using a structured form and classified reactions based on the EAACI/ENDA classification. Oral provocation tests with several NSAIDs were performed using a single-blind challenge per EAACI/ENDA guidelines. Results: Our retrospective study included 966 adult patients with a history of hypersensitivity to NSAIDs. The most common triggers were Acetylsalicylic Acid (ASA), paracetamol, and metamizole. The most prevalent acute NSAID hypersensitivity group was NSAID-induced urticaria/angioedema (NIUA) (34.3%). However, 17.3% of patients did not fit neatly into the current EAACI/ENDA classification. Notably, patients with underlying asthma or allergic rhinoconjunctivitis exhibited unusual reactions, such as urticaria and/or angioedema induced by multiple chemical groups of NSAIDs, blended mixed reactions, and isolated periorbital angioedema in response to multiple chemical groups of NSAIDs. Conclusions: While the EAACI/ENDA classification system stratifies NSAID-induced hypersensitivity reactions into five distinct endotypes or phenotypes, it may not fully capture the diversity of these reactions. Our findings suggest a need for further research to refine this classification system and better accommodate patients with atypical presentations (AU)
Palavras-chave
Texto completo:
1
Coleções:
06-national
/
ES
Base de dados:
IBECS
Assunto principal:
Anti-Inflamatórios não Esteroides
/
Hipersensibilidade a Drogas
Limite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Allergol. immunopatol
Ano de publicação:
2023
Tipo de documento:
Article