Department of Pediatrics, Division of Pulmonary, Allergy and Sleep Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Department of Biostatistics, Indiana University School of Medicine and Indiana Clinical and Translational Sciences Institute, Indianapolis, Indiana, USA.
Pediatr Pulmonol. 2023 Oct;58(10):2983-2986. doi: 10.1002/ppul.26618. Epub 2023 Jul 28.
: Asthma is a common pediatric disease. Identification of exacerbating factors is important to gain better asthma control. One potential exacerbation trigger is NSAID-hypersensitivity (NSAID-H). Studies regarding pediatric NSAID-H have varied demographics, methodologies, and conclusions. However, most studies find NSAID-H more prevalent in asthmatic patients.
: The objective was to determine the prevalence, symptoms, and factors associated with NSAID-H in a pediatric severe asthma population. One hundred children aged 6 to 18 years old from the Severe Asthma Clinic at Riley Hospital for Children in Indianapolis, IN, between 11/2020 and 5/2022 completed a survey about asthma triggers, allergies, co-morbid diagnoses, sinus symptoms, and NSAID reaction history.
: Nineteen percent of participants reported a reaction to at least one NSAID. Ibuprofen (16%), aspirin (9%), and acetaminophen (9%) were the most implicated NSAIDs. Most common symptoms were dyspnea, wheezing, coughing, lightheadedness, and abdominal pain appearing within 30 minutes. Associated factors included history of a medication other than an NSAID triggering asthma (p = 0.02), nasal polyps (p = 0.01), ageusia (p = 0.01), cold-induced asthma (p = 0.02), and chronic sinusitis in immediate family member (p = 0.04).
: Prevalence of NSAID-H in a large children’s hospital pediatric severe asthma clinic was 19%. The most common drug was ibuprofen and the most common symptoms were respiratory and gastrointestinal. Associated factors included medication and cold triggered asthma, nasal polyps, ageusia, and family history of chronic sinusitis. This highlights the importance of a thorough history in severe asthma patients who may be at higher risk for NSAID-H. Future studies should focus on looking at the rate of NSAID-H in a larger severe asthma population and if social determinants of health play a role in the increased incidence of reacting.
哮喘是一种常见的儿科疾病。识别加重因素对于获得更好的哮喘控制非常重要。一个潜在的加重触发因素是 NSAID 超敏反应（NSAID-H）。关于儿科 NSAID-H 的研究在人口统计学、方法学和结论上存在差异。然而，大多数研究发现哮喘患者中 NSAID-H 更为普遍。
本研究旨在确定印第安纳州印第安纳波利斯 Riley 儿童医院严重哮喘诊所的儿科严重哮喘患者中 NSAID-H 的患病率、症状和相关因素。2020 年 11 月至 2022 年 5 月期间，100 名年龄在 6 至 18 岁的儿童完成了一项关于哮喘诱因、过敏、合并诊断、鼻窦症状和 NSAID 反应史的调查。
19%的参与者报告至少有一种 NSAID 反应。布洛芬（16%）、阿司匹林（9%）和对乙酰氨基酚（9%）是最常见的 NSAID。最常见的症状是呼吸困难、喘息、咳嗽、头晕和腹痛，症状在 30 分钟内出现。相关因素包括除 NSAID 以外的药物触发哮喘的病史（p = 0.02）、鼻息肉（p = 0.01）、味觉丧失（p = 0.01）、冷诱导哮喘（p = 0.02）和直系亲属慢性鼻窦炎（p = 0.04）。
在一家大型儿童医院儿科严重哮喘诊所，NSAID-H 的患病率为 19%。最常见的药物是布洛芬，最常见的症状是呼吸道和胃肠道。相关因素包括药物和冷诱发哮喘、鼻息肉、味觉丧失和家族性慢性鼻窦炎。这凸显了在可能有更高 NSAID-H 风险的严重哮喘患者中进行详细病史询问的重要性。未来的研究应着眼于在更大的严重哮喘人群中观察 NSAID-H 的发生率，以及健康的社会决定因素是否在反应增加中发挥作用。
