Cofactors and comorbidities in patients with aspirin/NSAID hypersensitivity

• M.Sánchez-Borges ^[1] ; A.Capriles-Hulett ^[1] ; F.Caballero-Fonseca ^[1]
  1. [1] Centro Médico Docente La Trinidad

     Centro Médico Docente La Trinidad

     Venezuela

     
• Localización: Allergologia et immunopathologia: International journal for clinical and investigate allergology and clinical immunology, ISSN-e 1578-1267, ISSN 0301-0546, Vol. 45, Nº. 6, 2017, págs. 573-578
• Idioma: inglés
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• Resumen

  • 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.

    Abbreviations ADORA 3adenosine receptor 3 ACEisangiotensin-converting enzyme inhibitors AEangio-oedema AECDaspirin-exacerbated cutaneous disease AERDaspirin-exacerbated respiratory disease ASAaspirin CUchronic urticaria FDEIAfood-dependent exercise-induced anaphylaxis LTPlipid transfer protein NSAIDsnon-steroidal anti-inflammatory drugs U/AEUrticaria/angio-oedema