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Allergic Reactions: Anaphylaxis01:30

Allergic Reactions: Anaphylaxis

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Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity
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Published on: September 16, 2011

NSAID-sensitive antihistamine-induced urticaria/angioedema.

S Cimbollek1, M Ortega Camarero, R Avila

  • 1Allergy Department, Hospital Virgen del Rocío, Seville, Spain. scimbollek@gmail.com

Journal of Investigational Allergology & Clinical Immunology
|October 15, 2011
PubMed
Summary

This study details a rare case of antihistamine-induced urticaria in a patient with nonsteroidal anti-inflammatory drug (NSAID) sensitivity. Researchers identified a specific subset of antihistamine urticaria linked to NSAID sensitivity.

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Area of Science:

  • Allergy and Immunology
  • Pharmacology
  • Dermatology

Background:

  • Nonsteroidal anti-inflammatory drug (NSAID) sensitivity can manifest as hypersensitivity reactions.
  • Urticaria and angioedema are common allergic reactions, but drug-induced cases require careful diagnosis.

Observation:

  • A patient with NSAID sensitivity experienced immediate generalized urticaria with ibuprofen and naproxen.
  • Delayed urticarial reactions were noted after previous oral antihistamine use.
  • Skin tests for loratadine and cetirizine were negative, but oral challenge with loratadine induced urticaria.

Findings:

  • The patient developed urticaria and angioedema after a placebo-controlled oral challenge with piroxicam.
  • A subsequent oral challenge with loratadine resulted in generalized urticaria.
  • Fexofenadine was tolerated, suggesting specific antihistamine sensitivities.

Implications:

  • This case suggests a potential new subset of antihistamine-induced urticaria.
  • The condition is termed NSAID-sensitive antihistamine-induced urticaria/angioedema.
  • Further research is needed to understand the mechanisms and prevalence of this specific drug hypersensitivity.