Abstract
Reactions to nonopioid analgesics, antipyretics and nonsteroidal anti-inflammatory drugs (NSAIDs) may result from a specific/allergic hypersensitivity (HS), either IgE-mediated (immediate and very early reactions) or mediated by T-lymphocytes (delayed reactions), or from a non-specific/non-allergic HS (pharmacological « intolerance »), with a frequent cross-reactivity between the various chemical families of drugs, including paracetamol and, sometimes, coxibs. In patients with suspected allergic HS, diagnosis is usually based on a convincing clinical history and/or provocation tests (PT) showing that the patients react to the suspected drug (±other drugs in the same chemical family) but tolerate other (families of) drugs. However, although immediate and non-immediate-reading skin tests (ST) are specific when performed with non-irritant concentrations, they have a low sensitivity (≤25–30 %) and are not validated. In patients with non-allergic HS, skin tests are useless and diagnosis is based on a convincing clinical history and/or responses in PT. Considering also the low diagnostic value of in vitro tests, diagnosis of HS to analgesics-antipyretics-NSAIDs, whether allergic or non-allergic, is primarily based on clinical history of the patients and their responses in PT, and international consensus do not recommend skin tests.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call