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SELECTED ARTICLES FROM THE RECENT LITERATURE 2007
September 4, 2007
Autologous plasma skin tests in NSAID reactive patients
Summary
Background - Recent studies have shown that individuals with urticarial intolerances to multiple non-steroidal anti-inflammatory drugs (NSAID) have evidence of auto-reactivity as witnessed by positive autologous serum skin tests (APST). Does the APST help distinguish those with intolerance to multiple NSAID agents from those who react to one but not other NSAID?
Findings - Asero of the Clinica San Carlo in Italy carried out APST in a group of 30 patients with well documented urticarial reactions to at least one NSAID. At a later date, each subject was challenged with an alternative NSAID whose tolerance by the patient was not known.
In 16 of the 30 patients, oral challenge with an alternative NSAID induced an urticarial reaction. All 16 had previously manifested a positive APST. In contrast, only 3 of the 14 patients who did not react to a challenge with the alternative NSAID had a positive APST.
Reference
Int Arch Allergy Immunol 2007;144:226-30
Editor's Comments
As pointed out well by Stevenson and colleagues in the Scripps Clinic, some individuals react to just one NSAID (IgE mediated?) but not others while some other people react to multiple NSAID. The findings described above provide suggestive evidence that autoimmune reactions may play a role in the multiple NSAID reactions.
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