Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand,
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Int Arch Allergy Immunol. 2021;182(2):139-145. doi: 10.1159/000510364. Epub 2020 Sep 18.
Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) is reported to be the most common drug hypersensitivity. The aim of this study was to evaluate the characteristics of self-reported NSAID hypersensitivity and identify patients at high risk of NSAID hypersensitivity.
Patients who presented at a single tertiary care hospital between January-December 2017 with reported NSAID hypersensitivity were evaluated. Clinical information obtained from a review of medical records was further supplemented with data gained from a telephone-administered questionnaire.
From a total of 535 patients with reported NSAID hypersensitivity, 301 were included in the study. The mean age of onset of NSAID hypersensitivity reaction was 30.3 ± 14.9 years old. A total of 84 patients (27.9%) were hypersensitive to 2 or more chemically unrelated NSAIDs. The leading NSAID hypersensitivity was to propionic acid derivatives (73%) followed by acetic acid derivatives (28.9%). Immediate reaction (≤1 h) was identified in 171 patients (57.8%), and angioedema was the most frequently reported symptom (179 patients, 59.5%), followed by urticaria and anaphylaxis in 85 (28.2%) and 62 (20.6%) patients, respectively. A drug provocation test was performed on 53 patients, and NSAID hypersensitivity was confirmed in 38 patients (71.6%). The independent factors identified, which could predict NSAID hypersensitivity, were personal history of allergic rhinitis/chronic rhinosinusitis (AR/CRS), onset of NSAID hypersensitivity over 15 years old, and immediate reaction.
Angioedema was the most typical symptom, and propionic acid derivatives were the most frequently reported culprit drugs. The significant risk factors predicting NSAID hypersensitivity were personal history of AR/CRS, onset of NSAID hypersensitivity reaction over 15 years old, and immediate reaction.
非甾体抗炎药（NSAIDs）过敏反应据报道是最常见的药物过敏反应。本研究旨在评估自述 NSAIDs 过敏反应的特征，并确定 NSAIDs 过敏反应高危患者。
评估了 2017 年 1 月至 12 月期间在一家三级保健医院就诊的自述 NSAIDs 过敏反应的患者。从病历回顾中获取的临床信息，通过电话问卷调查进一步补充数据。
共有 535 例报告 NSAIDs 过敏反应的患者，其中 301 例纳入研究。NSAIDs 过敏反应发作的平均年龄为 30.3±14.9 岁。共有 84 例（27.9%）对 2 种或更多化学结构无关的 NSAIDs 过敏。导致 NSAIDs 过敏反应的主要 NSAIDs 是丙酸衍生物（73%），其次是乙酸衍生物（28.9%）。171 例（57.8%）患者出现即刻反应（≤1 小时），179 例（59.5%）患者最常报告的症状是血管性水肿，其次是荨麻疹和过敏反应，分别为 85 例（28.2%）和 62 例（20.6%）。对 53 例患者进行了药物激发试验，其中 38 例（71.6%）确认 NSAIDs 过敏反应。确定的可预测 NSAIDs 过敏反应的独立因素是过敏鼻炎/慢性鼻-鼻窦炎（AR/CRS）个人史、NSAIDs 过敏反应发病年龄超过 15 岁和即刻反应。
血管性水肿是最典型的症状，丙酸衍生物是最常报道的罪魁祸首药物。预测 NSAIDs 过敏反应的显著危险因素是 AR/CRS 个人史、NSAIDs 过敏反应发病年龄超过 15 岁和即刻反应。
