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Inicio Allergologia et Immunopathologia Cofactors and comorbidities in patients with aspirin/NSAID hypersensitivity
Journal Information
Vol. 45. Issue 6.
Pages 573-578 (November - December 2017)
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Vol. 45. Issue 6.
Pages 573-578 (November - December 2017)
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DOI: 10.1016/j.aller.2016.08.010
Cofactors and comorbidities in patients with aspirin/NSAID hypersensitivity
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M. Sánchez-Borgesa,b,
Corresponding author
sanchezbmario@gmail.com

Corresponding author.
, F. Caballero-Fonsecaa,c, A. Capriles-Huletta,c
a Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela
b Allergy Service, Clínica El Avila, Caracas, Venezuela
c Allergy Service, Centro Médico de Caracas, Caracas, Venezuela
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Figures (2)
Tables (4)
Table 1. Phenotypes of hypersensitivity reactions to NSAIDs.a
Table 2. Management of aspirin-exacerbated respiratory disease.
Table 3. Management of urticaria and angio-oedema induced by ASA/NSAIDs and aspirin-exacerbated cutaneous disease.
Table 4. Comorbidities and cofactors of aspirin/NSAID hypersensitivity.
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Abstract

Hypersensitivity reactions to aspirin and other NSAIDs occur in individuals genetically predisposed and exhibit different clinical manifestations, especially respiratory, cutaneous, and generalised. Five different phenotypes define distinct clinical pictures: aspirin-exacerbated respiratory disease, aspirin/NSAID cutaneous disease, NSAID-induced urticaria, angio-oedema and anaphylaxis, single NSAID reactions, and delayed reactions. They are observed more frequently in middle-aged women, and in atopic individuals. While ASA/NSAID hypersensitivity shares comorbidities with asthma, chronic rhinosinusitis, nasal polyposis, chronic urticaria and angio-oedema, ASA and other NSAIDs can also be cofactors for other clinically relevant conditions, especially food-dependent exercise-induced anaphylaxis, angio-oedema induced by angiotensin-converting enzyme inhibitors, and oral mite anaphylaxis. Awareness on these relationships is required for the correct diagnosis, classification, and treatment of affected patients.

Keywords:
Aspirin
Angio-oedema
Asthma
Non-steroidal anti-inflammatory drugs
Rhinosinusitis
Urticaria
Anaphylaxis
Abbreviations:
ADORA 3
ACEis
AE
AECD
AERD
ASA
CU
FDEIA
LTP
NSAIDs
U/AE

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