The historical factors associated with the true non-steroidal anti-inflammatory drug hypersensitivity in children
Yekbun Gamze Sayan1, Erdem Topal2
1Inonu University, Faculty of Medicine Department of Pediatrics, Malatya, Turkey
2Inonu University, Faculty of Medicine Department of Pediatric Immunology and Allergy, Malatya, Turkey
Aim: To determine the frequency of true NSAIDs hypersensitivity in children and whether there were any parameters in the history to predict NSAIDs hypersensitivity.
Material and Methods: Children who applied to outpatient clinic with a history suggesting NSAID hypersensitivity were evaluated by a pediatric allergist. The confirmed NSAID hypersensitivity was found by skin test and/or oral provocation tests.
Results: Fifty patients who were admitted with a suspicion of immediate-type reaction to NSAID were included in the study. The median age of the patients was 6 (1-16) years old and 28 (56%) of the patients were male. We performed skin tests with the suspected NSAID in 28 (56%) patients. Of these, 2 had positive results. Provocation tests were performed on 48 patients whose skin tests were negative or skin tests were not available. During the provocation tests, 11 patients (22%) developed reaction. Clinical parameters in history were evaluated by using univariate analysis; the age of child ≥ 6 years old (p=0.006), family history of NSAIDs hypersensitivity (p=0.039), presence of multiple immediate type NSAIDs hypersensitivity in history (p=0.01), emergence of reaction within an hour (p=0.004) were found as significant factors to predicted true NSAID hypersensitivity in history.
Conclusions: The diagnosis of immediate type NSAIDs hypersensitivity was not done by clinical history, oral provocation tests should be done for true diagnosis. However, the age of child ≥ 6 years old, family history of NSAIDs hypersensitivity, presence of multiple immediate type NSAIDs hypersensitivity in history, emergence of reaction within an hour in history can predict the true NSAIDs hypersensitivity