The historical factors associated with the true non-steroidal anti-inflammatory drug hypersensitivity in children

Abstract

Aim: To determine the frequency of true NSAIDs hypersensitivity in children and whether there were any parameters in the history to predict NSAIDs hypersensitivity. Material and Methods: Children who applied to outpatient clinic with a history suggesting NSAID hypersensitivity were evaluated by a pediatric allergist. The confirmed NSAID hypersensitivity was found by skin test and/or oral provocation tests. Results: Fifty patients who were admitted with a suspicion of immediate-type reaction to NSAID were included in the study. The median age of the patients was 6 (1-16) years old and 28 (56%) of the patients were male. We performed skin tests with the suspected NSAID in 28 (56%) patients. Of these, 2 had positive results. Provocation tests were performed on 48 patients whose skin tests were negative or skin tests were not available. During the provocation tests, 11 patients (22%) developed reaction. Clinical parameters in history were evaluated by using univariate analysis; the age of child ≥ 6 years old (p=0.006), family history of NSAIDs hypersensitivity (p=0.039), presence of multiple immediate type NSAIDs hypersensitivity in history (p=0.01), emergence of reaction within an hour (p=0.004) were found as significant factors to predicted true NSAID hypersensitivity in history. Conclusions: The diagnosis of immediate type NSAIDs hypersensitivity was not done by clinical history, oral provocation tests should be done for true diagnosis. However, the age of child ≥ 6 years old, family history of NSAIDs hypersensitivity, presence of multiple immediate type NSAIDs hypersensitivity in history, emergence of reaction within an hour in history can predict the true NSAIDs hypersensitivity