SELECTED ARTICLES FROM THE RECENT LITERATURE 2004

9/14/04

Adverse reactions to non-steroidal anti-inflammatory drugs

Summary
Background - The patterns of adverse reactions to non-steroidal anti-inflammatory drugs (NSAID) in adults has been extensively studied. Less is known about NSAID hypersensitivity in children.

Findings - Sanchez-Borges et al of the Centro Medico in Caracas, Venezuela reviewed the relevant literature and their own experience in the matter of cutaneous and respiratory adverse reactions to NSAID in pediatric patients. Although NSAID hypersensitivity is thought to occur less commonly in children than adults, about 20-25% of the NSAID adverse reactions may occur in those 8-18 years old. Such adverse reactions in children tend to be manifest as facial angioedema rather than primarily respiratory syndromes. The pediatric NSAID-reactivepatients are generally atopic and reactive to more than one NSAID. COX-2 specific inhibitors (e.g. celecoxib) are generally well tolerated in young NSAID reactive patients.

Reference
Pediatr Allergy Immunol 2004;15:376-80

Editor's Comments
My impression for some time has been re-enforced by the findings described above. NSAID "hypersensitivity" is less common in children than in adults. When it does occur, it is more commonly manifested as cutaneous but not respiratory reactions. Related to this is the relative paucity of nasal polyposis in children except that seen in children with cystic fibrosis. I was not aware that NSAID reactions in children is often manifest as facial angioedema as the major finding.

 

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