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Nsaids crossed hypersensitivity

Marcella Aquino, Greg Rosner
Systemic contact dermatitis (SCD) traditionally refers to a skin condition where an individual who is cutaneously sensitized to an allergen will subsequently react to that same allergen or a cross reacting allergen via a different route. It occurs to allergens including metals, medications, and foods. The exact pathophysiology underlying this disease remains unknown, although it appears to be mediated by type 4 hypersensitivity reactions and possibly type 3 hypersensitivity reactions. The p-I concept (pharmacologic interaction with immunoreceptors) hypothesized that drugs are able to bind directly to a T cell receptor without first being presented by MHC (major histocompatibility complex) molecules and without prior metabolism, which would help explain why SCD can be seen on first exposure to medications...
May 15, 2018: Clinical Reviews in Allergy & Immunology
Mona Al-Ahmad, Tito Rodriguez-Bouza, Midhat Nurkic
BACKGROUND: A history of nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity with cross-intolerance to several drugs is common in some patients with coronary artery disease. We present a series of patients with acute coronary syndrome undergoing ASA desensitization prior to a possible stent to evaluate the short- and long-term efficacy and safety. The aim was to evaluate the outcomes of an ASA desensitization protocol developed by our center based on the guidelines proposed by the EAACI drug allergy expert recommendations...
2018: International Archives of Allergy and Immunology
Natalia Blanca-López, Elisa Haroun-Diaz, Francisco Javier Ruano, Diana Pérez-Alzate, María Luisa Somoza, María Vázquez de la Torre Gaspar, Francisco Rivas-Ruiz, Elena García-Martin, Miguel Blanca, Gabriela Canto
BACKGROUND: Hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) in children are becoming a great concern. Most studies have focused on adults, with noted discrepancies observed in the classification of hypersensitivity reactions to NSAIDs in children when compared with adults. OBJECTIVE: To phenotype a group of children with hypersensitivity reactions to NSAIDs, including paracetamol, and analyze the degree of agreement with the entities reported in adults and how they fit the proposed classifications...
October 3, 2017: Journal of Allergy and Clinical Immunology in Practice
Natalia Blanca-Lopez, Diana Perez-Alzate, Gabriela Canto, Miguel Blanca
Non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequently involved in drug hypersensitivity reactions (DHR). NSAIDs are prescribed for different processes and some NSAIDs can be obtained over the counter. Areas covered: We analyse the practical approaches for managing and treating NSAID-DHR considering the five major groups of entities recognised, divided into two categories: those responding to strong COX-1 inhibitors and possibly weak COX-1 or selective COX-2 inhibitors named cross-intolerant (CI), and those induced by a single drug or drug group with good tolerance to strong COX-1 inhibitors, known as allergic reactions (SR)...
November 2017: Expert Review of Clinical Immunology
Hossein Esmaeilzedeh, Elmira Esmaeilzadeh, Mohammad Faramarzi, Mohammad Nabavi, Mohammad Farhadi
BACKGROUND: A clear association between allergy and nasal polyposis (NP) is not determined and the role of food intolerance in patients with NP is not investigated by oral food challenge (OFC). OBJECTIVE: To investigate the relation of salicylate food intolerance and atopy in patients with NP according to recurrence and aspirin sensitivity. METHODS: A cross sectional multicenter study was done in two tertiary centers for allergy in Iran. Adult patients with NP were selected for the study that had been referred to allergy clinics...
March 2017: Iranian Journal of Immunology: IJI
D Pérez-Alzate, J A Cornejo-García, N Pérez-Sánchez, I Andreu, A García-Moral, J A Agúndez, J Bartra, I Doña, M J Torres, M Blanca, N Blanca-López, G Canto
BACKGROUND AND OBJECTIVES: Individuals who develop drug hypersensitivity reactions (DHRs) to chemically unrelated nonsteroidal anti-inflammatory drugs (NSAIDs) are considered cross-hypersensitive. The hallmark for this classification is that the patient presents a reaction after intake of or challenge with acetylsalicylic acid (ASA). Whether patients react to 2 or more NSAIDs while tolerating ASA remains to be studied (selective reactions, SRs). Objective: To identify patients with SRs to 2 or more NSAIDs including strong COX-1 inhibitors...
2017: Journal of Investigational Allergology & Clinical Immunology
Tuğba Arikoglu, Gulen Aslan, Didem Derici Yildirim, Sehra Birgul Batmaz, Semanur Kuyucu
BACKGROUND: Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently encountered in daily clinical practice. The aim of this study was to determine the confirmation rates, risk factors of NSAID hypersensitivity in children and to try to classify them with a standardized diagnostic protocol. METHODS: All patients with a suspicion of NSAID-induced hypersensitivity were evaluated with European Network for drug Allergy (ENDA) recommendations...
July 2017: Allergology International: Official Journal of the Japanese Society of Allergology
Inmaculada Dona, Maria Salas, James R Perkins, Esther Barrionuevo, Francesco Gaeta, Jose A Cornejo-Garcia, Paloma Campo, Maria Jose Torres
Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the leading causes of hypersensitivity reactions to drugs, and they are classified in two groups: those induced by nonspecific immunological mechanisms (non-allergic or cross-intolerance (CI) reactions), or by specific immunological mechanisms (allergic or selective reactions (SR)). The pathogenesis of CI is associated with their pharmacological activity (COX-1 inhibition), with symptoms due to an imbalance in the arachidonic acid pathway, independently of their chemical structure...
2016: Current Pharmaceutical Design
D Pérez-Alzate, J A Cornejo-García, N Pérez-Sánchez, I Andreu, A García-Moral, J A Agúndez, J Bartra, I Doña, M J Torres, M Blanca, N Blanca-López, G Canto
BACKGROUND: Subjects who develop drug hypersensitivity reactions (DHRs) to chemically unrelated non-steroidal anti-inflammatory drugs (NSAIDs) are considered cross-hypersensitive. The hallmark for this category is that they present a reaction after ASA intake or challenge. Whether patients react to two or more NSAIDs with tolerance to ASA remains to be studied (selective reactions, SRs). OBJECTIVE: To identify patients with SRs to two or more NSAIDs including strong COX-1 inhibitors...
May 18, 2016: Journal of Investigational Allergology & Clinical Immunology
J A Cornejo-García, R Jurado-Escobar, I Doña, J R Perkins, J A Agúndez, E García-Martín, E Viguera, N Blanca-López, G Canto, M Blanca
DHRs are induced by various mechanisms and encompass a heterogeneous set of potentially life-threatening clinical entities. In addition to environmental effects, individual factors play a key role in this intricate puzzle. However, despite commendable efforts in recent years to identify individual predisposing factors, our knowledge of the genetic basis of these reactions remains incomplete. In this manuscript, we summarize current research on the genetics of DHRs, focusing on specific immune-mediated reactions (immediate and nonimmediate) and on pharmacologically mediated reactions (cross-intolerance to nonsteroidal anti-inflammatory drugs)...
2016: Journal of Investigational Allergology & Clinical Immunology
Blanca Noguerado-Mellado, Abdonias R Gamboa, Patricia R Perez-Ezquerra, Cristina M Cabeza, Roberto P Fernandez, Manuel De Barrio Fernandez
BACKGROUND: Naproxen is a non-steroidal anti-inflammatory drug (NSAID), belonging to propionic acid group, and its chemical structure is a 6-metoxi-metil-2-naftalenoacetic acid. Fixed drug eruptions (FDE) have been rarely reported. OBJECTIVE: A 38-year-old woman referred that after 2 hours of taking 2 tablets of naproxen for a headache, she developed several edematous and dusky-red macules, one on right forearm and the other two in both thighs and she was diagnosed with FDE probably due to naproxen...
2016: Recent Patents on Inflammation & Allergy Drug Discovery
Duy Le Pham, Ji-Hye Kim, Tu Hoang Kim Trinh, Hae-Sim Park
Nonsteroidal anti-inf lammatory drugs (NSAIDs) are widely prescribed for the treatment of inflammatory diseases, but their use is frequently related to hypersensitivity reactions. This review outlines our current knowledge of NSAID hypersensitivity (NHS) with regard to its pathogenic, molecular, and genetic mechanisms, as well as diagnosis and treatment. The presentation of NHS varies from a local (skin and/or airways) reaction to systemic reactions, including anaphylaxis. At the molecular level, NHS reactions can be classified as cross-reactive (mediated by cyclooxygenase inhibition) or selective (specific activation of immunoglobulin E antibodies or T cells)...
May 2016: Korean Journal of Internal Medicine
María Del Carmen Plaza-Serón, Pedro Ayuso, Natalia Pérez-Sánchez, Inmaculada Doña, Natalia Blanca-Lopez, Carlos Flores, Luisa Galindo, Ana Molina, James R Perkins, Jose A Cornejo-García, Jose A Agúndez, Elena García-Martín, Paloma Campo, Gabriela Canto, Miguel Blanca
OBJECTIVE: Cross-intolerance to NSAIDs is a class of drug hypersensitivity reaction, of which NSAIDs-induced urticaria and/or angioedema (NIUA) are the most frequent clinical entities. They are considered to involve dysregulation of the arachidonic acid pathway; however, this mechanism has not been confirmed for NIUA. In this work, we assessed copy number variations (CNVs) in eight of the main genes involved in the arachidonic acid pathway and their possible genetic association with NIUA...
June 2016: Pharmacogenetics and Genomics
N Blanca-López, D Pérez-Alzate, I Andreu, I Doña, J A Agúndez, E García-Martín, M Salas, M Á Miranda, M J Torres, J A Cornejo-García, M Blanca, G Canto
BACKGROUND: Although ibuprofen and other arylpropionic acid derivatives (APs) are the most common medicines involved in hypersensitivity drug reactions (HDRs) to NSAIDs, no patient series studies have been performed regarding immediate selective reactions (SRs) to these drugs. OBJECTIVE: To characterize patients with immediate selective HDRs to ibuprofen and other APs through clinical history and challenge. METHODS: Subjects who developed an HDR to APs less than 1 h after drug intake were included...
July 2016: Allergy
N Blanca-López, J A Cornejo-García, D Pérez-Alzate, N Pérez-Sánchez, M C Plaza-Serón, I Doña, M J Torres, G Canto, M Kidon, J R Perkins, M Blanca
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used throughout the world to treat pain and inflammation; however, they can trigger several types of drug hypersensitivity reactions (DHRs) in all age groups. Although most such reactions occur through activation of the leukotriene pathway without specific immunological recognition (cross-intolerance), a significant number of DHRs to NSAIDs are due to immunological mechanisms (selective reactions [SRs]). SRs are thought to be induced by specific IgE antibodies or by T cells...
2015: Journal of Investigational Allergology & Clinical Immunology
Ozlem Cavkaytar, Ebru Arik Yilmaz, Betul Karaatmaca, Betul Buyuktiryaki, Cansın Sackesen, Bulent E Sekerel, Ozge Soyer
BACKGROUND: Although non-steroidal anti-inflammatory drug hypersensitivity (NSAID-H) has been widely studied in adults, there is still a lack of data regarding the features and phenotypes of NSAID-H in children. Our aim was to define risk factors and different phenotypes according to clinical patterns. METHODS: Patients with a history of reaction to any NSAIDs referred between January 2012 and October 2014 were included. After completing a European Network for Drug Allergy (ENDA) questionnaire, initial skin and/or oral provocation tests (OPTs) were performed for the offending drug...
2015: International Archives of Allergy and Immunology
Hakan Guvenir, Emine Dibek Misirlioglu, Emine Vezir, Muge Toyran, Tayfur Ginis, Ersoy Civelek, Can N Kocabas
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAID) are the second-most frequent drugs that cause hypersensitivity reactions among children. Studies related to NSAIDs hypersensitivity in children are limited. In this study, we aimed to evaluate children admitted with suspicion of NSAIDs reaction. METHOD: Between January 1, 2011, and November 30, 2014, we included patients with suspicion of NSAIDs hypersensitivity in our clinic. For evaluation, skin tests and oral provocation tests with the drug (suspected or alternative) were proposed...
September 2015: Allergy and Asthma Proceedings:
C Rondón, I Dávila, A M Navarro Pulido, M C Sánchez, J Montoro, V Matheu, M Lluch-Bernal, B Fernández-Parra, M D Ibáñez, M T Dordal, C Colás, E Antón, A Valero
BACKGROUND: Nasal polyposis (NP) is a chronic inflammatory disease that constitutes a major health problem with significant comorbidities and a considerable associated socioeconomic burden. OBJECTIVE: To describe the clinical features and management of patients with NP attending Spanish allergy centers, the use of health care resources, and the degree of compliance with the diagnostic and therapeutic recommendations of the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS)...
2015: Journal of Investigational Allergology & Clinical Immunology
N Blanca-López, J A Cornejo-García, M C Plaza-Serón, I Doña, M J Torres-Jaén, G Canto, L Padilla-España, M Kidon, J R Perkins, M Blanca
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used worldwide and are responsible for several types of drug hypersensitivity reactions (DHRs) in all age groups. The 2 major groups of DHRs to NSAIDs are those induced by immunological mechanisms (selective reactions) and those where inflammatory mediators are released through activation of the prostaglandin-leukotriene pathway without specific immunological recognition (cross-intolerance). In the present review, we focus on cross-intolerance reactions, which are the most frequent DHRs and are becoming a topic of major interest in children and adolescents...
2015: Journal of Investigational Allergology & Clinical Immunology
Marek L Kowalski, Katharine Woessner, Marek Sanak
Nonsteroidal anti-inflammatory drug (NSAID)-induced urticarial and angioedema reactions are among the most commonly encountered drug hypersensitivity reactions in clinical practice. Three major clinical phenotypes of NSAID-induced acute skin reactions manifesting with angioedema, urticaria, or both have been distinguished: NSAID-exacerbated cutaneous disease, nonsteroidal anti-inflammatory drug-induced urticaria/angioedema (NIUA), and single NSAID-induced urticaria and angioedema. In some patients clinical history alone might be sufficient to establish the diagnosis of a specific type of NSAID hypersensitivity, whereas in other cases oral provocation challenges are necessary to confirm the diagnosis...
August 2015: Journal of Allergy and Clinical Immunology
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