Practical Guidelines for Diagnosing Hypersensitivity Reactions to Nonsteroidal Anti-inflammatory Drugs

N Ortega,1 I Doña,2 E Moreno,3 MT Audicana,4 MJ Barasona,5 MP Berges-Gimeno,6 N Blanca-Lopez,7 T Lobera,8 A Padial,9 A Rosado,10 MJ Torres2

1Allergy Service, Hospital Doctor Negrín, Las Palmas de Gran Canaria, Spain 2Allergy Unit, Hospital Regional Universitario de Málaga, Málaga, Spain 3Allergy Service, Hospital Universitario de Salamanca, Salamanca, Spain 4Allergy Service, Santiago Apóstol Hospital, Vitoria-Gasteiz, Spain 5Allergy Service, Reina Sofía University Hospital, Córdoba, Spain 6Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain 7Allergy Service, Infanta Leonor Hospital, Madrid, Spain 8Allergy Service, Centro de Alta Resolución San Millán, Logroño, Spain 9Allergy Service, La Paz Hospital, Madrid, Spain 10Allergy Service, Alcorcón Hospital, Madrid, Spain

J Investig Allergol Clin Immunol 2014; Vol. 24(5): 308-323

Abstract Nonsteroidal anti-inflammatory drugs (NSAIDs) are the drugs most frequently involved in hypersensitivity reactions. These reactions include various clinical entities with different mechanisms leading to the release of inflammatory mediators. Characterization of patients based on clinical manifestations and suspected underlying mechanisms is critical for implementation of adequate diagnostic procedures and patient management. Our objectives were to prepare a systematic review of available scientific evidence and to provide general guidelines for the diagnosis and management of patients with hypersensitivity reactions to NSAIDs. We also propose a practical algorithm for the diagnosis of specific types of hypersensitivity to NSAIDs and provide recommendations for the management of hypersensitive patients. Key words: Nonsteroidal anti-inflammatory drugs (NSAIDs). Hypersensitivity. Intolerance. Idiosyncrasy. Acetylsalicylic acid. Algorithm. Diagnosis.   Free Full-Text (PDF)   How to use PDF documents