{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:51:54Z","timestamp":1791564714689,"version":"4.3.4"},"reference-count":0,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Arch Allergy Immunol"],"abstract":"<jats:p>Background Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used in children, but NSAID hypersensitivity (NSAID-H) presents a heterogeneous clinical profile. Pediatric diagnostic approaches and real-life data after drug challenges (DCs) remain limited. Objective We aimed to evaluate the diagnostic algorithm for suspected pediatric NSAID-H and examine real-life drug use. Methods Children (1\u201318 years) evaluated for NSAID-H using WAO guidelines at a tertiary pediatric allergy center (Jan 2022\u2013Nov 2025) were included. Clinical histories, co-morbidities, and DC outcomes were recorded. Patients were classified as having single- or multiple-NSAID induced hypersensitivity. Positive patients underwent DCs for safe alternatives, and real-life tolerance was assessed. Results Of 62 included children, five had suspected immediate paracetamol reactions (one confirmed). Fifty-seven reported reactions to \u22652 unrelated NSAIDs; six were diagnosed via history alone. Of 51 children challenged with ASA\/ibuprofen, 14 (27.5%) were positive. Angioedema was the most frequent reaction; one experienced anaphylaxis following ibuprofen provocation. Single- and multiple-NSAID hypersensitivity rates were 20% (1\/5) and 35.1% (20\/57), respectively. Five patients already used paracetamol safely. For the remaining 14, safe alternatives identified were nimesulide (n=6) and meloxicam (n=4). One reacted to both, but tolerated codeine. Among 41 patients with excluded NSAID-H, 37 were contacted; 36 (97.3%) safely reused the culprit drug in real-life (one avoided due to maternal fear). Of 14 confirmed NSAID-H patients, 11 were contacted, all reporting safe alternative use without reactions. Conclusion Structured diagnostic algorithms and drug challenges ensure accurate diagnosis, reducing unnecessary NSAID restrictions and enabling safe real-life drug use in children. Key Words Acetyl salicylic acid, Children, Cyclooxygenase, Diagnosis, Drug allergy, Drug challenge, NSAID Hypersensitivity, Safe alternative, Real life.<\/jats:p>","DOI":"10.1159\/iaa\/adfag034","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:43:24Z","timestamp":1791459804000},"source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Algorithm and Real-Life Data in Pediatric Patients Suspected of NSAID Hypersensitivity"],"prefix":"10.1159","author":[{"given":"Melis","family":"OZTURK AYKAC","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eren","family":"Sari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozlem","family":"Yilmaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,10,8]]},"container-title":["International Archives of Allergy and Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/iaa\/adfag034","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:01:52Z","timestamp":1791561712000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/iaa\/adfag034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1159\/iaa\/adfag034","archive":["Portico"],"relation":{},"ISSN":["1018-2438","1423-0097"],"issn-type":[{"value":"1018-2438","type":"print"},{"value":"1423-0097","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]}}}