Allergy Department, Hospital Virgen del Rocío, Seville, Spain.
J Investig Allergol Clin Immunol. 2011;21(6):488-90.
We present a case of urticaria caused by antihistamines in a patient with nonsteroidal anti-inflammatory drug (NSAID) sensitivity. A 35-year-old man experienced, on 2 separate occasions, immediate generalized urticaria during treatment with ibuprofen and naproxen, respectively. A single-blind, placebo-controlled oral challenge (SBPCOC) with piroxicam was carried out, and resulted in urticaria and angioedema 3 hours later. Two hours after initial clinical resolution, the patient developed multiple wheals on the trunk and upper limbs. He described similar delayed reactions after oral antihistamine administration on previous occasions. SBPCOCs with acetaminophen and etoricoxib were performed, with good tolerance. Skin prick and patch tests with loratadine and cetirizine were negative. After an SBPCOC with loratadine, the patient developed generalized urticaria 90 minutes after intake. Tolerance to fexofenadine 180 mg was confirmed. We describe the first case of a possible new subset of antihistamine urticaria, and suggest calling this NSAID-sensitive antihistamine-induced urticaria/angioedema.
我们报告了一例抗组胺药引起的荨麻疹病例，该患者对非甾体抗炎药（NSAID）敏感。一名 35 岁男性在分别使用布洛芬和萘普生治疗时，出现了 2 次即时全身性荨麻疹。进行了吡罗昔康的单盲、安慰剂对照口服激发试验（SBPCOC），结果在 3 小时后出现了荨麻疹和血管性水肿。初始临床缓解后 2 小时，患者的躯干和上肢出现多个风团。他之前在口服抗组胺药后也有类似的迟发性反应。进行了对乙酰氨基酚和依托考昔的 SBPCOC，耐受性良好。氯雷他定和西替利嗪的皮肤点刺和斑贴试验均为阴性。在进行氯雷他定的 SBPCOC 后，患者在摄入后 90 分钟出现全身性荨麻疹。确认了对非索非那定 180mg 的耐受性。我们描述了首例可能的新的抗组胺药荨麻疹亚类，并建议将其称为 NSAID 敏感的抗组胺药诱导的荨麻疹/血管性水肿。
