Hoefnagel Juliette J, Wehmeijer Kristel, Terreehorst Ingrid, van Zuuren Esther J
Leids Universitair Medisch Centrum, afd. Dermatologie, Leiden, the Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A1854.
Angio-oedema and urticaria can be symptoms of both allergic (IgE-mediated) and non-allergic drug hypersensitivity reactions. Non-allergic drug reactions, that may have a similar clinical presentation as allergic drug reactions, are not caused by an IgE-mediated immune mechanism. Because of unfamiliarity with non-allergic drug reactions and the unclear time course between drug use and reactions, the relationship with the responsible drug is often not recognized, leading to unnecessary patient risks. In the present article three patients with angio-oedema and urticaria as side effects of frequently used drugs (ACE-inhibitors, NSAIDs and betalactams) are presented and discussed. Patient A was a 69-year-old man with ACE-inhibitor induced angio-oedema. Patient B was a 40-year-old woman with urticaria and angio-oedema after ingestion of a NSAID caused by a non-allergic drug reaction. Patient C was a 54-year-old woman who developed an anaphylactic shock because of a type I allergy to betalactams.
血管性水肿和荨麻疹可能是过敏性（IgE介导）和非过敏性药物超敏反应的症状。非过敏性药物反应可能具有与过敏性药物反应相似的临床表现，但并非由IgE介导的免疫机制引起。由于对非过敏性药物反应不熟悉，以及用药与反应之间的时间进程不明确，与致病药物的关系往往未被识别，从而给患者带来不必要的风险。本文介绍并讨论了三名因常用药物（血管紧张素转换酶抑制剂、非甾体抗炎药和β-内酰胺类）出现血管性水肿和荨麻疹副作用的患者。患者A是一名69岁男性，因血管紧张素转换酶抑制剂诱发血管性水肿。患者B是一名40岁女性，因非过敏性药物反应在摄入非甾体抗炎药后出现荨麻疹和血管性水肿。患者C是一名54岁女性，因对β-内酰胺类药物I型过敏而发生过敏性休克。
