Abstract

CALADO, Gisela et al. Nonsteroidal anti-inflammatory drugs hypersensitivity in pediatric patients with asthma. Rev Port Imunoalergologia [online]. 2012, vol.20, n.4, pp.273-280. ISSN 0871-9721.

Background: Published data on the frequency of nonsteroidal anti -inflammatory drugs (NSAIDs) hypersensitivity in asthmatic patients are very discrepant, being scarce in pediatric patients. Our aim was to estimate the frequency of NSAIDs hypersensitivity, reported by phone enquiry, in asthmatic patients with pediatric age. Methods: We included all the pediatric patients (6 -17 years) with clinical diagnosis of asthma, confirmed by a positive bronchodilation test performed during the period between 1st August of 2008 and 30th November of 2010.A phone inquiry was applied to ask about the occurrence of a drug adverse reaction, namely to NSAIDs. When a NSAIDs adverse reaction was confirmed, further details were asked: drug involved, age at the first reaction, clinical symptoms, time between drug intake and onset of symptoms, reproducibility of reaction, eviction of the culprit drug and tolerance of some alternative. Results: A positive bronchodilation test was found in 184 patients. It was possible to apply our phone enquiry to 111/184 (60.3%). The majority (59.4%) were boys, with 11±3.1 years. Nine patients (8.1%) reported a hypersensitivity reaction to NSAIDs, which were reproducible in 3. The first reaction occurred at a median age of 2 years (P25: 1.8; P75: 5.75), below 10 years old in all patients. In all cases ibuprofen was the involved drug and paracetamol was tolerated. All patients reported immediate reactions, with the following clinical manifestations: respiratory (7), cutaneous (3), and gastrointestinal (1). The reported frequency of respiratory symptoms as clinical manifestation of adverse reaction to AINEs among these asthmatic patients was 6.3% (7/111). Four patients (3.6%) were on eviction of NSAIDs, although they have never had any adverse reaction.Conclusions: The reported frequency of AINEs hypersensitivity goes against data that describes theses reactions as infrequent below 10 years old. Paracetamol seems to be a safe alternative

Keywords : Aspirin-exacerbated respiratory disease; asthma; hypersensitivity; non steroidal anti-inflammatory; pediatric patients.

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