title: [Hypersensitivity reactions to non-steroidal anti-inflammatory drugs and tolerance to alternative drugs].
abstract: BACKGROUND
  Hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAIDs) are the most common reactions to drugs. The prevalence varies from 0.6 to 5.7% in general population, but there are no data available in children. The aim of this study is to determine the frequency of patients diagnosed with hypersensitivity to NSAIDs, and describe their clinical characteristics, type of hypersensitivity, and tolerance to alternative drugs.
  
  
  METHODS
  Retrospective study was conducted on children with suspected hypersensitivity to NSAIDs from January 2012 to December 2013. The diagnosis was confirmed by oral drug provocation test (DPT) to the drug involved in the group with a history of one episode, while in the group with a history of more than one episode with the same drug the diagnosis was based on clinical data. Subsequently, a DPT with acetylsalicylic acid (ASA) was done in order to classify hypersensitivity into selective or multiple. In those cases with a positive result, a DPT was performed with alternative drugs.
  
  
  RESULTS
  Out of a total of 93 children studied, 26 were diagnosed with hypersensitivity to NSAIDs: 7 confirmed by oral DPT, and 19 based on clinical data. Multiple hypersensitivity was diagnosed in 50% of patients. Ibuprofen was involved in all reactions. The most common clinical manifestation was angioedema (44%). Acetaminophen was the best tolerated alternative drug.
  
  
  CONCLUSIONS
  More than one quarter (28%) of the population studied was diagnosed with hypersensitivity to NSAIDs, and 50% had multiple hypersensitivity. Acetaminophen is a safe alternative in children with hypersensitivity to NSAIDs. Meloxicam may be an alternative in cases that do not tolerate acetaminophen.
authors.affiliation: Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España.
authors.forename: K
authors.initials: K
authors.lastname: Calvo Campoverde
authors.affiliation: Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España.
authors.forename: M T
authors.initials: MT
authors.lastname: Giner-Muñoz
authors.affiliation: Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España.
authors.forename: L
authors.initials: L
authors.lastname: Martínez Valdez
authors.affiliation: Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Rojas Volquez
authors.affiliation: Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Lozano Blasco
authors.affiliation: Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Machinena
authors.affiliation: Servicio de Alergia e Inmunología Clínica Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España. Electronic address: aplaza@hsjdbcn.es.
authors.forename: A M
authors.initials: AM
authors.lastname: Plaza
mesh_terms: D000082:Acetaminophen; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D057915:Drug Substitution; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D007052:Ibuprofen
keywords: Alternative drugs; Drug provocation test; Fármacos alternativos; Hipersensibilidad a antiinflamatorios no esteroideos; Hipersensibilidad múltiple; Hipersensibilidad selectiva; Hypersensitivity to non-steroidal anti-inflammatory drugs; Multiple hypersensitivity; Prueba de exposición controlada; Selective hypersensitivity