Clinical findings of sensitivity to analgesics and nonsteroidal antiinflammatory drugs

Abstract

BACKGROUND: Analgesics (ANA) and nonsteroidal antiinflammatory drugs (NSAID) may simulate an allergic reaction or aggravate asthma and urticaria. OBJECTIVE: The aim of this study was the analysis of the clinical findings in patients sensitive to ANA/NSAID. METHODS AND SUBJECTS: The charts of 183 patients with history of reacting to these drugs were retrospectively analysed. RESULTS: There were 93 (51%) females and 90 (49%) males; 63 (34%) were aged 15 years or less. Females predominate in the age group older than 15 years (p = 0,02). The age by the time of the first reaction varied from 7 months to 65 years (median 15 years). Skin tests to inhalant allergens were positive to at least one antigen in 100/138 patients (72%). Clinical presentation was angioedema (86%); urticaria (39%); systemic reaction (30%); nasal and ocular (15%); and asthma (14%). The frequency of symptoms was not related to age. Family history of ANA/NSAID sensitivity was present in 3.8% of patients. Associated diseases were rhinitis (55%), chronic urticaria (47%), asthma (37%) and conjuntivitis (18%). Among asthmatics 16 (23,5%) had had attacks with ANA/NSAID. Nine non asthmatics (7.7%) had had bronchospasm as clinical presentation. This difference was statistically significant. Repeated reactions occurred in 107 (58%) patients. CONCLUSIONS: Sensitivity to ANA/NSAID was frequent in atopics; children and adults responded similarly; reactions were more common in adult females; palpebral angioedema was the most frequent clinical presentation; bronchosphasm was usually seen in asthmatics and most patients reacted repeatedly to different drugs.