Immediate reactions to more than 1 NSAID must not be considered cross-hypersensitivity unless tolerance to asa is verified

Background: individuals who develop drug hypersensitivity reactions (dhrs) to chemically unrelated nonsteroidal anti-inflammatory drugs (nsaids) are considered cross-hypersensitive. the hallmark for this classification is that the patient presents a reaction after intake of or challenge with acetylsalicylic acid (asa). whether patients react to 2 or more nsaids while tolerating asa remains to be studied (selective reactions,srs). objective: to identify patients with srs to 2 or more nsaids including strong cox-1 inhibitors. methods: patients who attended the allergy service of hospital infanta leonor,madrid,spain with dhrs to nsaids between january 2011 and december 2014 were evaluated. those with 2 or more immediate reactions occurring in less than 1 hour after intake were included. after confirming tolerance to asa,the selectivity of the response to 2 or more nsaids was demonstrated by in vivo and/or in vitro testing or by controlled administration. results: from a total of 203 patients with immediate dhrs to nsaids,16 (7.9%) met the inclusion criteria. the patients presented a total of 68 anaphylactic or cutaneous reactions (mean [sd],4.2 [2.1]). most reactions were to ibuprofen and other arylpropionic acid derivatives and to metamizole. two different nsaids were involved in 11 patients and 3 in 5 patients. conclusions: patients with nsaid-induced anaphylaxis or urticaria/angioedema should not be considered cross-hypersensitive unless tolerance to asa is verified. © 2017 esmon publicidad.