Abstract | BACKGROUND: Previous studies show skin reactions after exposure to acetaminophen and/or nimesulide to occur in about 10% of patients with a history of urticaria induced by aspirin or other nonsteroidal anti-inflammatory drugs ( NSAIDs). This fact is surprising since cross-reactivity among different NSAIDs should not occur among subjects without a history of chronic urticaria. OBJECTIVE: METHODS: Two hundred fifty-six patients with a history of recent pseudoallergic skin reactions caused by NSAIDs underwent elective oral challenges with increasing doses of both acetaminophen and nimesulide. Patients were divided into three groups: A = 69 subjects with chronic urticaria, B = 163 otherwise normal subjects with a history of urticaria after the ingestion of aspirin, and C = 24 otherwise normal subjects with a history of urticaria after the ingestion of pyrazolones but aspirin-tolerant. RESULTS: CONCLUSIONS: In at least 20% of patients with a history of urticaria/ angioedema or anaphylaxis induced by aspirin or other NSAIDs, but without a history of chronic urticaria, cross-reactivity with other NSAIDs occurs. Atopy as well as a history of aspirin-induced anapylactoid reactions seem to represent relevant risk factors for intolerance to alternative NSAIDs. In view of these findings, aspirin-intolerant patients with such clinical features should be submitted to peroral tolerance tests with at least two alternative substances in order to avoid potentially severe reactions.
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Authors | R Asero |
Journal | Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
(Ann Allergy Asthma Immunol)
Vol. 82
Issue 6
Pg. 554-8
(Jun 1999)
ISSN: 1081-1206 [Print] United States |
PMID | 10400483
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Analgesics, Non-Narcotic
- Anti-Bacterial Agents
- Anti-Inflammatory Agents, Non-Steroidal
- Cyclooxygenase Inhibitors
- Sulfonamides
- Acetaminophen
- nimesulide
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Topics |
- Acetaminophen
(adverse effects)
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Analgesics, Non-Narcotic
(adverse effects)
- Anti-Bacterial Agents
(adverse effects)
- Anti-Inflammatory Agents, Non-Steroidal
(adverse effects)
- Cyclooxygenase Inhibitors
(adverse effects)
- Drug Hypersensitivity
(epidemiology, etiology)
- Female
- Humans
- Hypersensitivity, Delayed
(chemically induced)
- Hypersensitivity, Immediate
(chemically induced)
- Male
- Middle Aged
- Risk Factors
- Skin Diseases
(chemically induced)
- Sulfonamides
(adverse effects)
- Urticaria
(chemically induced)
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