title: [Analysis of 76 patients with urticaria and angioedema induced by non-steroidal anti-inflammatory drugs (NSAIDs) in Japan].
abstract: BACKGROUND
  The pathogenesis of urticaria and angioedema induced by non-steroidal anti-inflammatory drugs (NSAIDs) is still obscure. We analyzed the clinical characteristics of patients with NSAIDs-induced urticaria and angioedema without asthma in Japan.
  
  
  METHODS
  We retrospectively collected the cases of NSAIDs-induced urticaria and angioedema from Japanese medical journals in 2000-2009.
  
  
  RESULTS
  Seventy-six patients were analyzed. The male/female ratio was 1:2.5 and the mean age was 38.1 years. Urticaria was most frequent clinical manifestation in 3 groups; urticaria alone, urticaria and angioedema, and angioedema alone. Time interval from drug administration to onset was 5 minutes to 48 hours by aspirin at a dose of 25-1000 mg. Skin prick test was performed with aspirin in 33 patients, and the results were negative in all patients. Meloxicam, a selective cyclooxygenase-2 (COX-2) inhibitor, and celecoxib, a new selective COX-2 inhibitor, were administered safely in 4 of 6 patients and in 2 of 3 patients with NSAIDs-induced urticaria, respectively. These drugs were administered safely in all administered patients with NSAIDs-induced angioedema. Tiaramidehydrochroride (a basic COX-1 inhibitor) was safely used in 23 administered patients with NSAIDs-induced angioedema. Leukotriene receptor antagonists were effective in 2 of 5 patients administered, but aggravated symptoms in the others.
  
  
  CONCLUSIONS
  Diversity of NSAIDs-induced urticaria and angioedema was shown in this study. Pathogenesis of NSAIDs-induced urticaria and angioedema without asthma seems to be different from that of NSAIDs-induced asthma.
authors.affiliation: Department of Dermatology, Yokohama City University School of Medicine, Yokohama, Japan. mogumogumakimaki@hotmail.co.jp
authors.forename: Maki
authors.initials: M
authors.lastname: Moriya
authors.forename: Michiko
authors.initials: M
authors.lastname: Aihara
authors.forename: Rie
authors.initials: R
authors.lastname: Hirota
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hirata
authors.forename: Naoko
authors.initials: N
authors.lastname: Ikinaga
authors.forename: Naoko
authors.initials: N
authors.lastname: Takamura
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kunimi
authors.forename: Takahisa
authors.initials: T
authors.lastname: Uchida
authors.forename: Zenro
authors.initials: Z
authors.lastname: Ikezawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000799:Angioedema / Q000139:chemically induced* / Q000453:epidemiology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D014581:Urticaria / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal