Hacettepe University, School of Medicine, Department of Chest Diseases, Adult Allergy Unit, 06100 Sihhiye, Ankara, Turkey.
Respir Med. 2013 Jul;107(7):967-74. doi: 10.1016/j.rmed.2013.03.014. Epub 2013 Apr 30.
Characteristics of non-steroidal anti-inflammatory drug (NSAID)-hypersensitivity (NH) associated with underlying/accompanying diseases has not been studied in Turkey. In addition, the factors associated with asthma in NH patients are not well known. The present study aimed to investigate the relationship between NH and chronic urticaria, rhinitis/rhinosinusitis, and asthma in an effort to identify NH phenotypes. The study's secondary aim was to identify the factors associated with asthma in NH patients and the NSAID reaction pattern in asthmatics.
Data for 1137 NH patients in our hospital's allergy clinic database were retrospectively analyzed. Patients were divided into 5 groups based on their accompanying diseases (chronic urticaria, asthma, rhinitis/rhinosinusitis). Asthmatic patients were compared to non-asthmatic patients to identify the factors associated with asthma.
Reaction patterns and patient characteristics in each group differed from those in the reference group (NH only group). Asthma in patients with NH was associated with female gender, sinonasal polyposis/polyp surgery, rhinitis/rhinosinusitis, NSAID-induced rhinitis/asthma or a blended reaction pattern, immediate reaction following NSAID intake, self-reported history of food allergy, and family history of asthma; the odds ratios and 95% CIs were 1.35 (1.02-1.78), 13.52 (8.74-20.9)/10.94 (6.73-17.77), 12.06 (9-16.17), 15.28 (10.45-22.36)/2.43 (1.70-3.45), 1.76 (1.31-2.35), 1.49 (1.04-2.14), and 3.1 (2.35-4.08), respectively. The characteristics of the asthmatic patients that had urticaria/angioedema-type reactions to NSAID intake (pseudo Samter's syndrome) differed from those in the asthmatics with rhinitis/asthma-type reactions.
Chronic urticaria, rhinitis, and asthma commonly accompany NH. NSAID response patterns in NH patients may help differentiate groups of patients. The present study identified factors associated with asthma in NH patients and observed that there seems to be different phenotypes of Samter's syndrome, for which a new classification scheme was proposed.
在土耳其，尚未研究非甾体抗炎药（NSAID）过敏（NH）与潜在/伴随疾病之间的特征关系。此外，与 NH 患者哮喘相关的因素也不明确。本研究旨在调查 NH 与慢性荨麻疹、鼻炎/鼻窦炎和哮喘之间的关系，以确定 NH 表型。该研究的次要目的是确定 NH 患者中与哮喘相关的因素以及哮喘患者中 NSAID 反应模式。
回顾性分析我院过敏诊所数据库中 1137 例 NH 患者的数据。根据伴随疾病（慢性荨麻疹、哮喘、鼻炎/鼻窦炎）将患者分为 5 组。将哮喘患者与非哮喘患者进行比较，以确定与哮喘相关的因素。
各组的反应模式和患者特征与参考组（仅 NH 组）不同。NH 患者的哮喘与女性、鼻旁窦息肉/息肉手术、鼻炎/鼻窦炎、NSAID 诱导的鼻炎/哮喘或混合反应模式、NSAID 摄入后即刻反应、自述食物过敏史和哮喘家族史相关；比值比和 95%CI 分别为 1.35（1.02-1.78）、13.52（8.74-20.9）/10.94（6.73-17.77）、12.06（9-16.17）、15.28（10.45-22.36）/2.43（1.70-3.45）、1.76（1.31-2.35）、1.49（1.04-2.14）和 3.1（2.35-4.08）。对 NSAID 摄入有荨麻疹/血管性水肿型反应（假性 Samter 综合征）的哮喘患者的特征与有鼻炎/哮喘型反应的哮喘患者不同。
慢性荨麻疹、鼻炎和哮喘常伴有 NH。NH 患者的 NSAID 反应模式可能有助于区分患者群体。本研究确定了 NH 患者中与哮喘相关的因素，并观察到 Samter 综合征似乎存在不同的表型，为此提出了一种新的分类方案。
