Predictive value of autologous plasma skin test for multiple nonsteroidal anti-inflammatory drug intolerance.
BACKGROUND
Recent studies show that patients with multiple nonsteroidal anti-inflammatory drug (NSAID) intolerance are frequently characterized by autoreactivity; this can be detected by autologous serum skin test (ASST).


OBJECTIVE
To assess whether the autologous plasma skin test (APST), a test that was recently shown to be more sensitive than ASST, may be usefully employed as a predictive test for multiple NSAID intolerance in patients with a history of single NSAID intolerance.


METHODS
Thirty otherwise normal adults with a history of acute urticaria following the ingestion of one single NSAID underwent an APST before being challenged with a COX-1-inhibiting NSAID other than the offending drug.


RESULTS
Sixteen patients experienced urticaria following the ingestion of the alternative NSAID and were therefore classified as multiple NSAID reactors; all 16 (100%) scored positive on APST. In contrast only 3/14 patients finally classified as single NSAID reactors were positive on APST (p < 0.001). The positive and negative predictive value of APST for multiple NSAID intolerance were 86 and 100%, respectively.


CONCLUSIONS
In patients with a history of acute urticaria induced by a single NSAID APST can be usefully employed to detect patients that are prone to react to NSAID other than the original offending one.
Asero
Riccardo
R
Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy. r.asero@libero.it
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000097:blood / Q000276:immunology; D004342:Drug Hypersensitivity / Q000097:blood / Q000175:diagnosis* / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012882:Skin Tests; D014581:Urticaria / Q000097:blood / Q000276:immunology
D000894:Anti-Inflammatory Agents, Non-Steroidal