title: Cofactors and comorbidities in patients with aspirin/NSAID hypersensitivity.
abstract: Hypersensitivity reactions to aspirin and other NSAIDs occur in individuals genetically predisposed and exhibit different clinical manifestations, especially respiratory, cutaneous, and generalised. Five different phenotypes define distinct clinical pictures: aspirin-exacerbated respiratory disease, aspirin/NSAID cutaneous disease, NSAID-induced urticaria, angio-oedema and anaphylaxis, single NSAID reactions, and delayed reactions. They are observed more frequently in middle-aged women, and in atopic individuals. While ASA/NSAID hypersensitivity shares comorbidities with asthma, chronic rhinosinusitis, nasal polyposis, chronic urticaria and angio-oedema, ASA and other NSAIDs can also be cofactors for other clinically relevant conditions, especially food-dependent exercise-induced anaphylaxis, angio-oedema induced by angiotensin-converting enzyme inhibitors, and oral mite anaphylaxis. Awareness on these relationships is required for the correct diagnosis, classification, and treatment of affected patients.
authors.affiliation: Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela; Allergy Service, Clínica El Avila, Caracas, Venezuela. Electronic address: sanchezbmario@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Borges
authors.affiliation: Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela; Allergy Service, Centro Médico de Caracas, Caracas, Venezuela.
authors.forename: F
authors.initials: F
authors.lastname: Caballero-Fonseca
authors.affiliation: Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela; Allergy Service, Centro Médico de Caracas, Caracas, Venezuela.
authors.forename: A
authors.initials: A
authors.lastname: Capriles-Hulett
mesh_terms: D000485:Allergens / Q000276:immunology; D000799:Angioedema / Q000453:epidemiology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000276:immunology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000276:immunology; D001241:Aspirin / Q000276:immunology; D001249:Asthma / Q000453:epidemiology*; D002908:Chronic Disease; D015897:Comorbidity; D004342:Drug Hypersensitivity / Q000453:epidemiology*; D006801:Humans; D009298:Nasal Polyps / Q000453:epidemiology*; D012220:Rhinitis / Q000453:epidemiology*; D012852:Sinusitis / Q000453:epidemiology*; D014581:Urticaria / Q000453:epidemiology*
chemical_list: D000485:Allergens; D000806:Angiotensin-Converting Enzyme Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
keywords: Anaphylaxis; Angio-oedema; Aspirin; Asthma; Non-steroidal anti-inflammatory drugs; Rhinosinusitis; Urticaria