The value of the clinical history for the diagnosis of immediate nonsteroidal anti-inflammatory drug hypersensitivity and safe alternative drugs in children

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dc.authoridtopal, erdem/0000-0002-4439-2689;
dc.authorwosidtopal, erdem/ABI-7545-2020
dc.authorwosidCeliksoy, Mehmet Halil/A-3889-2015
dc.contributor.authorTopal, Erdem
dc.contributor.authorCeliksoy, Mehmet Halil
dc.contributor.authorCatal, Ferhat
dc.contributor.authorSayan, Yekbun Gamze
dc.contributor.authorSancak, Recep
dc.date.accessioned2024-08-04T20:43:12Z
dc.date.available2024-08-04T20:43:12Z
dc.date.issued2016
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground: Diagnosing hypersensitivity reactions that develop as a result of nonsteroidal anti-inflammatory drugs (NSAID) with a history is mostly misleading, and skin tests and/or provocation tests are needed for a definitive diagnosis. Objective: To determine the frequency of actual NSAID hypersensitivity and whether there are any parameters in the history to predict NSAID hypersensitivity. In addition, to determine safe alternative drugs for children who are diagnosed with actual NSAID hypersensitivity. Methods: Children with a history of NSAID hypersensitivity were evaluated by an allergist. Safe alternatives in children with a confirmed NSAID hypersensitivity were found by oral provocation tests. Results: Sixty-four patients who were admitted with a suspicion of immediate-type reaction to NSAIDs were included in the study. The median age of the patients was 6 years old (range, 1-17 years), and 37 of the patients (57.8%) were boys. We performed skin tests for suspected NSAID in 35 patients (54.7%). Of these, two had positive results. Provocation tests were performed with 62 patients whose skin test results were negative or for whom skin tests were not available. During the provocation tests, 16 patients (25.8%) developed reactions. Low- and high-dose acetaminophen, nimesulide, and tolmetin sodium were used to find safe alternative drugs. Two patients developed reactions to high-dose acetaminophen but no reaction to nimesulide and tolmetin sodium. When statistically significant parameters were analyzed in a logistic regression model, the presence of multiple NSAIDs hypersensitivity in the patient history (odds ratio 26.6 [95% confidence interval, 1.47-481.63]; p = 0.026) and the emergence of a reaction within an hour (odds ratio 26.4 [95% confidence interval, 1.73-403.11]; p = 0.019) were found as the independent factors to predicted actual NSAID hypersensitivity. Conclusion: The emergence of a reaction within an hour of taking the drug and the presence of multiple NSAIDs hypersensitivity history increased the possibility of actual NSAID hypersensitivity. Nimesulide, low-dose acetaminophen, and tolmetin sodium could be used as safe alternative drugs in patients with multiple NSAIDs hypersensitivity.en_US
dc.identifier.doi10.2500/aap.2016.37.3917
dc.identifier.endpage63en_US
dc.identifier.issn1088-5412
dc.identifier.issn1539-6304
dc.identifier.issue1en_US
dc.identifier.pmid26831848en_US
dc.identifier.scopus2-s2.0-85020351688en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage57en_US
dc.identifier.urihttps://doi.org/10.2500/aap.2016.37.3917
dc.identifier.urihttps://hdl.handle.net/11616/97849
dc.identifier.volume37en_US
dc.identifier.wosWOS:000369161600014en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherOcean Side Publications Incen_US
dc.relation.ispartofAllergy and Asthma Proceedingsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectProvocation Testsen_US
dc.subjectNsaid Hypersensitivityen_US
dc.subjectIntoleranceen_US
dc.subjectInhibitorsen_US
dc.subjectTolmetinen_US
dc.titleThe value of the clinical history for the diagnosis of immediate nonsteroidal anti-inflammatory drug hypersensitivity and safe alternative drugs in childrenen_US
dc.typeArticleen_US

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