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首页> 外文期刊>Clinical and experimental allergy : >Value of the clinical history in the diagnosis of urticaria/angioedema induced by NSAIDs with cross-intolerance
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Value of the clinical history in the diagnosis of urticaria/angioedema induced by NSAIDs with cross-intolerance

机译：临床病史在交叉耐受性非甾体抗炎药引起的荨麻疹/血管性水肿的诊断中的价值

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Background: Multiple Non-steroidal anti-inflammatory drugs (NSAID)-induced urticaria/angioedema is the most common manifestation of hypersensitivity reactions to NSAIDs. Diagnostic evaluation is based on the clinical history and a drug provocation test. Objective: To evaluate the role of the clinical history in the diagnosis of multiple NSAID-induced urticaria/angioedema. Methods: We studied a group of patients with an unequivocal history of urticaria and/or angioedema after NSAID intake. Subjects had to have had at least two episodes of cutaneous symptoms with two different COX-1 inhibitors. The diagnosis was confirmed in all cases by a drug provocation test with acetyl salicylic acid (ASA). Multivariate analysis was done by analysing different variables, including number of drugs involved, episodes and time elapsed between drug intake and symptom onset. Results: Of the total group of 75 cases with multiple NSAID-induced urticaria/angioedema diagnosed according to the clinical history, 76% developed a positive drug provocation test with ASA. The risk for having hypersensitivity was 17 times higher in patients who developed symptoms within the first 60 min after drug intake, 13 times higher in those who experienced reactions with more than two non-chemically related NSAIDs, and 10 times higher in women. Conclusions: Drug provocation testing with ASA confirms the diagnosis of multiple NSAID-induced urticaria/angioedema in up to 92% of cases with an unequivocal clinical history, when reactions occur within 1 h and more than two different NSAIDs are involved.
机译：背景：多种非甾体抗炎药（NSAID）引起的荨麻疹/血管性水肿是对NSAID过敏反应的最常见表现。诊断评估基于临床病史和药物激发试验。目的：评估临床病史在诊断多发性非甾体抗炎药引起的荨麻疹/血管性水肿中的作用。方法：我们研究了一组服用NSAID后明确的荨麻疹和/或血管性水肿病史的患者。受试者必须患有至少两种使用两种不同的COX-1抑制剂的皮肤症状。在所有情况下，通过乙酰水杨酸（ASA）的药物激发试验均证实了该诊断。多变量分析是通过分析不同的变量来完成的，这些变量包括所涉及的药物数量，发作次数和药物摄入与症状发作之间的时间间隔。结果：在根据临床病史诊断出的多发由NSAID引起的荨麻疹/血管性水肿的75例患者中，有76％的患者使用ASA进行了阳性药物激发试验。在服用药物后60分钟内出现症状的患者出现超敏反应的风险高17倍，与两种以上非化学相关的NSAID发生反应的患者高过敏的风险高，女性高10倍。结论：使用ASA进行的药物激发试验证实，在1小时内发生反应且涉及两种以上不同的NSAID的情况下，多达92％的具有明确临床病史的病例可诊断出多发NSAID引起的荨麻疹/血管性水肿。

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