The Frequency of Nonsteroidal Anti-Inflammatory Drug Hypersensitivity in Children with Asthma

Int Arch Allergy Immunol. 2018;176(1):26-32. doi: 10.1159/000487305. Epub 2018 Mar 28.

Abstract

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are the second-most frequent drug type to cause hypersensitivity reactions in children. Asthma is one of the risk factors for NSAID hypersensitivity (NSAID-H) in adult patients. There are limited number of studies evaluating NSAID-H among children with asthma. Our aim was to assess the frequency of confirmed NSAID-H and evaluate the classification of NSAID-H in children with asthma.

Methods: Patients followed with a diagnosis of asthma in our Pediatric Allergy Clinic were evaluated for NSAID-H. Patients were questioned whether they had used NSAIDs, and if they experienced any reaction with these drugs. A control group was also questioned for reactions to NSAID use.

Results: 976 children with asthma and 2,000 healthy children as a control group were included in this study. The mean age of the patients with asthma was 10.61 ± 4.21 years and 59.5% were male. Ten (1%) had a reaction history to NSAIDs. NSAID-H was confirmed in 9 (0.9%) who were tested with the suspected drugs. Six of these were classified as "single NSAID-induced urticaria/angioedema or anaphylaxis" and 3 were classified as "NSAIDs-exacerbated respiratory disease." In the control group, only 1 subject had a reaction history to acetylsalicylic acid and no reaction developed in the provocation test.

Conclusions: In our study, NSAID-H was found more frequent in children with asthma than in the control group. Children with asthma should be evaluated for reactions to NSAIDs during hospital visits.

Keywords: Asthma; Children; Drug provocation test; Hypersensitivity; Nonsteroidal anti-inflammatory drugs.

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Asthma / complications*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / epidemiology
  • Drug Hypersensitivity / etiology*
  • Female
  • Humans
  • Male
  • Risk Factors

Substances

  • Anti-Inflammatory Agents, Non-Steroidal