{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T05:33:48Z","timestamp":1761975228467},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,6,14]],"date-time":"2012-06-14T00:00:00Z","timestamp":1339632000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background:\u2002<\/jats:bold> Urticaria, angioedema and anaphylaxis are common adverse reactions to non\u2010steroidal anti\u2010inflammatory drugs (NSAIDs).<\/jats:p><jats:p><jats:bold>Aim:\u2002<\/jats:bold> To investigate the clinical characteristics of NSAID\u2010induced acute hypersensitivity reactions with structured oral drug challenges.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> Patients with NSAID\u2010induced urticaria, angioedema or anaphylaxis were challenged with either the homologous NSAID to confirm diagnosis or a heterologous NSAID to investigate cross\u2010reactivity. Data were analysed retrospectively and supplemented by a telephone questionnaire.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Sixty\u2010eight patients (mean age 48.3, 53 females) reported a total of 75 instances of NSAID\u2010induced reactions of which 64% were purely cutaneous and 36% were systemic anaphylaxis. Ibuprofen was the most frequent cause of reactions (35%), however, diclofenac was the most frequent cause of anaphylaxis (48%). Seventeen out of 40 (43%) homologous NSAID challenges were positive; presentation with anaphylaxis or reaction to diclofenac predicted a positive challenge. Only 7 of 28 (25%) of heterologous NSAID challenges were positive. Structured challenges enabled us to identify 23 (34%) patients with selective reactivity to a single NSAID, 19 (28%) patients with cross\u2010reactivity to multiple NSAIDs and 23 (34%) patients in whom NSAID hypersensitivity was not reproduced. Selective reactors presented most often with anaphylaxis and some had a background of beta\u2010lactam antibiotic allergy. Cross\u2010reactive patients often had a background of chronic urticaria and presented with milder reactions.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> In the absence of a reliable <jats:italic>in vitro<\/jats:italic> test, structured drug challenges allow identification of selective and cross\u2010reactive NSAID hypersensitivity syndromes. NSAID\u2010induced anaphylaxis is often associated with selective hypersensitivity and patients may not need to avoid other NSAIDs.<\/jats:p>","DOI":"10.1111\/j.1445-5994.2011.02601.x","type":"journal-article","created":{"date-parts":[[2011,10,7]],"date-time":"2011-10-07T21:15:08Z","timestamp":1318022108000},"page":"665-671","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Oral drug challenges in non\u2010steroidal anti\u2010inflammatory drug\u2010induced urticaria, angioedema and anaphylaxis"],"prefix":"10.1111","volume":"42","author":[{"given":"T.","family":"Chaudhry","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Hissaria","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Wiese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Heddle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Kette","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. 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