EAACI/GA2LEN guideline: aspirin provocation tests for diagnosis of aspirin hypersensitivity.
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most common causes of adverse drug reactions. Majority of them are of the hypersensitivity type. The two frequent clinical presentations of aspirin hypersensitivity are: aspirin-induced bronchial asthma/rhinosinusitis (AIA/R) and aspirin-induced urticaria/angioedema (AIU). The decisive diagnosis is based on provocation tests with aspirin, as the in vitro test does not hold diagnostic value as yet. Detailed protocols of oral, bronchial and nasal aspirin provocation tests are presented. Indications, contraindications for the tests, the rules of drug withdrawal and equipment are reviewed. Patient supervision and interpretations of the tests are proposed.
Nizankowska-Mogilnicka
E
E
Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland.
Bochenek
G
G
Mastalerz
L
L
Swierczyńska
M
M
Picado
C
C
Scadding
G
G
Kowalski
M L
ML
Setkowicz
M
M
Ring
J
J
Brockow
K
K
Bachert
C
C
Wöhrl
S
S
Dahlén
B
B
Szczeklik
A
A
D000284:Administration, Oral; D000485:Allergens / Q000008:administration & dosage; D000799:Angioedema / Q000139:chemically induced / Q000453:epidemiology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced / Q000175:diagnosis; D001985:Bronchial Provocation Tests / Q000379:methods / Q000592:standards*; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D005060:Europe; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000139:chemically induced / Q000175:diagnosis*; D009299:Nasal Provocation Tests / Q000379:methods / Q000592:standards*; D017410:Practice Guidelines as Topic; D012680:Sensitivity and Specificity; D014581:Urticaria / Q000139:chemically induced / Q000453:epidemiology
D000485:Allergens; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin