{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T19:35:30Z","timestamp":1777318530396,"version":"3.51.4"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T00:00:00Z","timestamp":1647388800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical &amp; Translational All"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Nonsteroidal anti\u2010inflammatory drugs (NSAIDs) are frequently avoided in mastocytosis, because of a potential increased risk for drug hypersensitivity reactions (DHRs) due to inhibition of cyclo\u2010oxygenase (COX), subsequent depletion of prostaglandin <jats:italic>E<\/jats:italic><jats:sub>2<\/jats:sub> and release of leukotrienes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Here, we aimed at determining the prevalence of mast cell (MC) mediator release symptoms triggered by NSAIDs in mastocytosis patients and the associated clinical and laboratory features of the disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical records from 418 adults to 223 pediatric mastocytosis patients were retrospectively reviewed. Patients were classified according to tolerance patterns to NSAIDs and other COX inhibitors (COXi) and compared for epidemiological, clinical and laboratory findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 87% of adults and 91% of pediatric patients tolerated NSAIDs and other COXi. Among adult and pediatric patients presenting DHRs, 5% and 0% reacted to multiple NSAIDs, 4% and 0.7% were single reactors, and 3% and 8% were single reactors with known tolerance to paracetamol but unknown tolerance to other COXi, respectively. Among adults, hypersensitivity to \u22652 drugs was more frequent among females (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.009), patients with prior history of anaphylaxis to triggers other than NSAIDs or other COXi and <jats:italic>Hymenoptera<\/jats:italic> venom (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.009), presence of baseline flushing (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.02), baseline serum tryptase \u226548\u00a0ng\/ml (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.005) and multilineage <jats:italic>KIT<\/jats:italic> mutation (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.02). In contrast, tolerance to NSAIDs and other COXi was more frequent among males (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.02), in patients with anaphylaxis caused by <jats:italic>Hymenoptera<\/jats:italic> venom (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.02), among individuals who had skin lesions due to mastocytosis (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.01), and in cases that had no baseline pruritus (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.006). Based on these parameters, a score model was designed to stratify mastocytosis patients who have never received NSAIDs or other COXi apart from paracetamol, according to their risk of DHR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results suggest that despite the frequency of MC mediator related symptoms elicited by NSAIDs and other COXi apart from paracetamol is increased among mastocytosis patients versus the general population, it is lower than previously estimated and associated with unique disease features. Patients that tolerated NSAIDs and other COXi following disease onset should keep using them. In turn, adults with unknown tolerance to such drugs and a positive score should be challenged with a preferential\/selective COX\u20102 inhibitor, while the remaining may be challenged with ibuprofen.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clt2.12132","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T17:34:20Z","timestamp":1647452060000},"source":"Crossref","is-referenced-by-count":25,"title":["Mastocytosis presenting with mast cell\u2010mediator release\u2010associated symptoms elicited by cyclo oxygenase inhibitors: prevalence, clinical, and laboratory features"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0134-617X","authenticated-orcid":false,"given":"Tiago Azenha","family":"Rama","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o  Porto Portugal"},{"name":"Servi\u00e7o de Imunologia Departamento de Patologia Faculdade de Medicina da Universidade do Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3770-2458","authenticated-orcid":false,"given":"Jos\u00e9 M\u00e1rio","family":"Morgado","sequence":"additional","affiliation":[{"name":"Instituto de Estudios de Mastocitosis de Castilla La Mancha and CIBERONC CB16\/12\/00400 Hospital Virgen del Valle  Toledo Spain"},{"name":"Spanish Network on Mastocytosis (REMA)  Toledo and Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5096-791X","authenticated-orcid":false,"given":"Ana","family":"Henriques","sequence":"additional","affiliation":[{"name":"Instituto de Estudios de Mastocitosis de Castilla La Mancha and CIBERONC CB16\/12\/00400 Hospital Virgen del Valle  Toledo Spain"},{"name":"Spanish Network on Mastocytosis (REMA)  Toledo and Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Escribano","sequence":"additional","affiliation":[{"name":"Spanish Network on Mastocytosis (REMA)  Toledo and Salamanca Spain"},{"name":"Servicio General de Citometr\u00eda Centro de Investigaci\u00f3n del C\u00e1ncer (IBMCC\u2010CSIC\/USAL and IBSAL) CIBERONC CB16\/12\/00400 and Departamento de Medicina Universidad de Salamanca  Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1190-4473","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Alvarez\u2010Twose","sequence":"additional","affiliation":[{"name":"Instituto de Estudios de Mastocitosis de Castilla La Mancha and CIBERONC CB16\/12\/00400 Hospital Virgen del Valle  Toledo Spain"},{"name":"Spanish Network on Mastocytosis (REMA)  Toledo and Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1757-7255","authenticated-orcid":false,"given":"Laura","family":"Sanchez\u2010Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Instituto de Estudios de Mastocitosis de Castilla La Mancha and CIBERONC CB16\/12\/00400 Hospital Virgen del Valle  Toledo Spain"},{"name":"Spanish Network on Mastocytosis (REMA)  Toledo and Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7294-9296","authenticated-orcid":false,"given":"Andr\u00e9","family":"Moreira","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o  Porto Portugal"},{"name":"Servi\u00e7o de Imunologia Departamento de Patologia Faculdade de Medicina da Universidade do Porto  Porto Portugal"},{"name":"EPIUnit Instituto de Sa\u00fade P\u00fablica da Universidade do Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Rom\u00e3o","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas de Abel Salazar  Porto Portugal"},{"name":"Servi\u00e7o de Anestesiologia Centro Hospitalar do Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0007-7230","authenticated-orcid":false,"given":"Alberto","family":"\u00d3rf\u00e3o","sequence":"additional","affiliation":[{"name":"Spanish Network on Mastocytosis (REMA)  Toledo and Salamanca Spain"},{"name":"Servicio General de Citometr\u00eda Centro de Investigaci\u00f3n del C\u00e1ncer (IBMCC\u2010CSIC\/USAL and IBSAL) CIBERONC CB16\/12\/00400 and Departamento de Medicina Universidad de Salamanca  Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9547-4844","authenticated-orcid":false,"given":"Almudena","family":"Matito","sequence":"additional","affiliation":[{"name":"Instituto de Estudios de Mastocitosis de Castilla La Mancha and CIBERONC CB16\/12\/00400 Hospital Virgen del Valle  Toledo Spain"},{"name":"Spanish Network on Mastocytosis (REMA)  Toledo and Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2014.02.003"},{"key":"e_1_2_11_3_1","first-page":"291","volume-title":"World Health Organization (WHO) Classification of Tumours Pathology\u00a0& Genetics Tumours of Haematopoietic and Lymphoid Tissues","author":"Valent P","year":"2001"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12916"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.10.015"},{"key":"e_1_2_11_6_1","volume-title":"WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues","author":"Horny H\u2010P","year":"2017"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.05.008"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/HS9.0000000000000646"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020006157"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.18176\/jiaci.0327"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-002-0575-z"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.10.063"},{"key":"e_1_2_11_13_1","volume-title":"Guidelines for ATC Classification and DDD Assignment","author":"WHO Collaborating Centre for Drug Statistics Methodology","year":"2019"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10787-013-0172-x"},{"key":"e_1_2_11_15_1","first-page":"249","article-title":"Factores epidemiol\u00f3gicos, cl\u00ednicos y socioecon\u00f3micos de las enfermedades al\u00e9rgicas en Espa\u00f1a","author":"Sastre J","year":"2005","journal-title":"Sociedad Espa\u00f1ola Alergia Inmunol Cl\u00edn"},{"key":"e_1_2_11_16_1","volume-title":"Alergol\u00f3gica 2015; Draft Grupo de Comunicaci\u00f3n Healthcare","author":"Ib\u00e1\u00f1ez\u2010Sand\u00edn MD","year":"2017"},{"key":"e_1_2_11_17_1","first-page":"574","article-title":"Prevalence of hypersensitivity reactions to nonsteroidal anti\u2010inflammatory drugs in 212 patients with mastocytosis in Spain","volume":"64","author":"Sanchez\u2010Matas I","year":"2009","journal-title":"Allergy"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2007.02804.x"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01569.x"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12225"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13445"},{"issue":"106","key":"e_1_2_11_22_1","first-page":"670","article-title":"Nonsteroidal anti\u2010inflammatory drug hypersensitivity in patients with clonal mast cell disorders \u2013 an exaggerated risk?","volume":"74","author":"Jarkvist J","year":"2019","journal-title":"Allergy"},{"key":"e_1_2_11_23_1","first-page":"320","article-title":"Pediatric cutaneous mastocytosis: a review of 180 cases","volume":"7","author":"Ben\u2010Amitai D","year":"2005","journal-title":"Isr Med Assoc J"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12260"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000444798"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2003.12.323"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2007.080903"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1301753"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.12.002"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2126(01)00038-8"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2126(01)00041-8"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2126(01)00021-2"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-04-015545"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/WOX.0b013e318211496c"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2007.01807.x"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2011.02557.x"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40521-017-0128-2"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.06.020"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.02.008"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.12.1578"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2012.12.002"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2019.09.003"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020008948"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2009.10.020"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjp.0707239"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.06-8061com"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12617"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2015.72"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.02.019"}],"container-title":["Clinical and Translational Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clt2.12132","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/clt2.12132","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clt2.12132","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T10:42:18Z","timestamp":1692960138000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clt2.12132"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":48,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1002\/clt2.12132"],"URL":"https:\/\/doi.org\/10.1002\/clt2.12132","archive":["Portico"],"relation":{},"ISSN":["2045-7022","2045-7022"],"issn-type":[{"value":"2045-7022","type":"print"},{"value":"2045-7022","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3]]},"article-number":"e12132"}}