非甾体抗炎药超敏反应：并非总是过敏！

Nonsteroidal anti-inflammatory drug hypersensitivity: not always an allergy!

作者信息

Hermans M A W, Otten R, Karim A F, van Maaren M S

机构信息

Department of Internal Medicine, section Allergy and Clinical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands.

出版信息

Neth J Med. 2018 Mar;76(2):52-59.

PMID:29515006

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a major cause of hypersensitivity reactions. Several distinct clinical syndromes are described regarding NSAID hypersensitivity. Such a reaction is generally caused by a non-immunological mechanism. In susceptible patients, COX-1 inhibition leads to an imbalance in lipid mediators such as leukotrienes and prostaglandins. It is essential to distinguish multiple nonspecific NSAID hypersensitivity from single NSAID hypersensitivity, since the management of these respective syndromes is essentially different. This review provides an overview on all the aspects of NSAID hypersensitivity reactions, from pathophysiology to clinical symptoms, leading practical recommendations.

摘要

非甾体抗炎药（NSAIDs）是超敏反应的主要原因。关于NSAIDs超敏反应，有几种不同的临床综合征被描述。这种反应通常由非免疫机制引起。在易感患者中，COX-1抑制会导致脂质介质如白三烯和前列腺素失衡。区分多种非特异性NSAIDs超敏反应和单一NSAIDs超敏反应至关重要，因为这两种综合征的治疗方法本质上不同。本综述概述了NSAIDs超敏反应从病理生理学到临床症状的各个方面，并给出了实用建议。