title: Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA(#) and GA2LEN/HANNA*.
abstract: Nonsteroidal anti-inflammatory drugs (NSAIDs) are responsible for 21-25% of reported adverse drug events which include immunological and nonimmunological hypersensitivity reactions. This study presents up-to-date information on pathomechanisms, clinical spectrum, diagnostic tools and management of hypersensitivity reactions to NSAIDs. Clinically, NSAID hypersensitivity is particularly manifested by bronchial asthma, rhinosinusitis, anaphylaxis or urticaria and variety of late cutaneous and organ-specific reactions. Diagnosis of hypersensitivity to a NSAID includes understanding of the underlying mechanism and is necessary for prevention and management. A stepwise approach to the diagnosis of hypersensitivity to NSAIDs is proposed, including clinical history, in vitro testing and/or provocation test with a culprit or alternative drug depending on the type of the reaction. The diagnostic process should result in providing the patient with written information both on forbidden and on alternative drugs.
authors.affiliation: Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Poland. marek.kowalski@csk.umed.lodz.pl
authors.forename: Marek L
authors.initials: ML
authors.lastname: Kowalski
authors.forename: J S
authors.initials: JS
authors.lastname: Makowska
authors.forename: M
authors.initials: M
authors.lastname: Blanca
authors.forename: S
authors.initials: S
authors.lastname: Bavbek
authors.forename: G
authors.initials: G
authors.lastname: Bochenek
authors.forename: J
authors.initials: J
authors.lastname: Bousquet
authors.forename: P
authors.initials: P
authors.lastname: Bousquet
authors.forename: G
authors.initials: G
authors.lastname: Celik
authors.forename: P
authors.initials: P
authors.lastname: Demoly
authors.forename: E R
authors.initials: ER
authors.lastname: Gomes
authors.forename: E
authors.initials: E
authors.lastname: Niżankowska-Mogilnicka
authors.forename: A
authors.initials: A
authors.lastname: Romano
authors.forename: M
authors.initials: M
authors.lastname: Sanchez-Borges
authors.forename: M
authors.initials: M
authors.lastname: Sanz
authors.forename: M J
authors.initials: MJ
authors.lastname: Torres
authors.forename: A
authors.initials: A
authors.lastname: De Weck
authors.forename: A
authors.initials: A
authors.lastname: Szczeklik
authors.forename: K
authors.initials: K
authors.lastname: Brockow
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000276:immunology; D001241:Aspirin / Q000009:adverse effects* / Q000276:immunology; D001249:Asthma / Q000139:chemically induced / Q000175:diagnosis; D002648:Child; D004342:Drug Hypersensitivity / Q000145:classification / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D005060:Europe; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000139:chemically induced; D017410:Practice Guidelines as Topic; D014581:Urticaria / Q000139:chemically induced / Q000175:diagnosis
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin