Food-dependent NSAID-induced hypersensitivity (FDNIH) reactions: Unraveling the clinical features and risk factors.
drug allergy
food allergy
non-steroidal anti-inflammatory drug
Journal
Allergy
ISSN: 1398-9995
Titre abrégé: Allergy
Pays: Denmark
ID NLM: 7804028
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
10
10
2020
received:
09
01
2020
accepted:
19
10
2020
pubmed:
9
12
2020
medline:
22
5
2021
entrez:
8
12
2020
Statut:
ppublish
Résumé
In up to 70%-80% of patients with a suspected non-steroidal anti-inflammatory drug hypersensitivity (NSAIDH), challenge tests with the culprit drug yield negative results. On the other hand, there could be a NSAIDH overdiagnosis when anaphylaxis is the clinical manifestation. We hypothesize that some negative NSAID challenge tests and an overdiagnosis of NSAIDH occur in patients with food-dependent NSAID-induced hypersensitivity (FDNIH). We studied 328 patients with a suspected acute NSAIDH. FDNIH was diagnosed in patients meeting all the following: (1) tolerance to the food ingested more temporally closed before the reaction, later the episode, (2) respiratory or cutaneous symptoms or anaphylaxis related to NSAID, (3) positive skin prick test to foods and/or specific IgE to food allergens (Pru p 3, Tri a 19, Pen a 1) involved in the reaction, and (4) negative oral provocation test to the culprit NSAID. 199 patients (60%) were diagnosed with NSAIDH and 52 (16%) with FDNIH. Pru p 3 was involved in 44 cases (84.6%) and Tri a 19 in 6 cases (11%). FDNIH subjects were younger (p < .001), with a higher prevalence of rhinitis (p < .001) and previous food allergy (p < .001), together with a higher proportion of subjects sensitized to pollens (p < .001) and foods (p < .001). Using just four variables (Pru p 3 sensitization, Tri a 19 sensitization, anaphylaxis, and any NSAID different from pyrazolones), 95.3% of cases were correctly classified, with a sensitivity of 92% and specificity of 96%. Evaluation of FDNIH should be included in the diagnostic workup of NSAIDH.
Sections du résumé
BACKGROUND
In up to 70%-80% of patients with a suspected non-steroidal anti-inflammatory drug hypersensitivity (NSAIDH), challenge tests with the culprit drug yield negative results. On the other hand, there could be a NSAIDH overdiagnosis when anaphylaxis is the clinical manifestation. We hypothesize that some negative NSAID challenge tests and an overdiagnosis of NSAIDH occur in patients with food-dependent NSAID-induced hypersensitivity (FDNIH).
METHODS
We studied 328 patients with a suspected acute NSAIDH. FDNIH was diagnosed in patients meeting all the following: (1) tolerance to the food ingested more temporally closed before the reaction, later the episode, (2) respiratory or cutaneous symptoms or anaphylaxis related to NSAID, (3) positive skin prick test to foods and/or specific IgE to food allergens (Pru p 3, Tri a 19, Pen a 1) involved in the reaction, and (4) negative oral provocation test to the culprit NSAID.
RESULTS
199 patients (60%) were diagnosed with NSAIDH and 52 (16%) with FDNIH. Pru p 3 was involved in 44 cases (84.6%) and Tri a 19 in 6 cases (11%). FDNIH subjects were younger (p < .001), with a higher prevalence of rhinitis (p < .001) and previous food allergy (p < .001), together with a higher proportion of subjects sensitized to pollens (p < .001) and foods (p < .001). Using just four variables (Pru p 3 sensitization, Tri a 19 sensitization, anaphylaxis, and any NSAID different from pyrazolones), 95.3% of cases were correctly classified, with a sensitivity of 92% and specificity of 96%.
CONCLUSION
Evaluation of FDNIH should be included in the diagnostic workup of NSAIDH.
Substances chimiques
Allergens
0
Anti-Inflammatory Agents, Non-Steroidal
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1480-1492Informations de copyright
© 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
Références
Kowalski ML, Makowska JS, Blanca M, et al. Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) classification, diagnosis and management: review of the EAACI/ENDA and GA2LEN/HANNA. Allergy. 2011;66:818-829.
Kowalski ML, Asero R, Bavbek S, et al. Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs. Allergy. 2013;68:1219-1232.
Caimmi S, Caimmi D, Bousquet PJ, Demoly P. How can we better classify NSAID hypersensitivity reactions?-validation from a large database. Int Arch Allergy Immunol. 2012;159:306-312.
Arikoglu T, Aslan G, Yildirim DD, Batmaz SB. Discrepancies in the diagnosis and classification of nonsteroidal anti-inflammatory drug hypersensitivity reactions in children. Allergol Intern. 2017;66:418-424.
Cavkaytar O, Yilmaz EA, Karaatmaca B, et al. Different phenotypes of non-steroidal anti-inflammatory drug hypersensitivity during childhood. Int Arch Allergy Immunol. 2015;167:211-221.
Demir S, Olgac M, Unal D, Gelincik A, Colakoglu B, Buyukozturk S. Evaluation of hypersensitivity reactions to nonsteroidal anti-inflammatory drugs according to the latest classification. Allergy. 2015;70:1461-1467.
Nissen CV, Bindslev-Jensen C, Mortz C. Hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs): classification of a Danish patient cohort according to EAACI/ENDA guidelines. Clin Transl Allergy. 2015;5:10.
Viola M, Rumi G, Valluzzi RL, Gaeta F, Caruso C, Romano A. Assessing potential determinants of positive provocation tests in subjects with NSAID hypersensitivity. Clin Exp Allergy. 2010;41:96-103.
Nwaru BI, Hickstein L, Panesar SS, Roberts G, Muraro A, Sheikh A. EAACI Food Allergy and Anaphylaxis Guidelines Group. Prevalence of common food allergies in Europe: a systematic review and meta-analysis. Allergy. 2014;69:992-1007.
Lyons SA, Burney PGJ, Ballmer-Weber BK, et al. Food Allergy in Adults: Substantial Variation in Prevalence and Causative Foods Across Europe. J Allergy Clin Immunol Pract. 2019;7(6):1920-1928.
Panesar SS, Javad S, de Silva D, et al. The epidemiology of anaphylaxis in Europe: a systematic review. Allergy. 2013;68:1353-1361.
Tejedor Alonso MA, Moro Moro M, Mugica Garcia MV. Epidemiology of anaphylaxis. Clin Exp Allergy. 2015;45:1027-1039.
Wang J, Sampson HA. Food anaphylaxis. Clin Exp Allergy. 2007;37:651-660.
Simons FE, Ardusso LR, Dimov V, et al. World Allergy Organization Anaphylaxis Guidelines: 2013 update of the evidence base. Intern Archiv Allergy immunol. 2013;162:193-204.
Sampson HA, Aceves S, Bock SA, et al. Food allergy: a practice parameter update-2014. J Allergy Clin immunol. 2014;134:1016-1025.
Worm M, Edenharter G, Rueff F, et al. Symptom profile and risk factors of anaphylaxis in Central Europe. Allergy. 2012;67(5):691-698.
Wolbing F, Fischer J, Koberle M, Kaesler S, Biedermann T. About the role and underlying mechanisms of cofactors in anaphylaxis. Allergy. 2013;68(9):1085-1092.
Oropeza AR, Bindslev-Jensen C, Broesby-Olsen S, et al. Patterns of anaphylaxis after diagnostic work-up: A follow-up study of 226 patients with suspected anaphylaxis. Allergy. 2017;72(12):1944-1952.
Moneret-Vautrin DA, Latarche C. Drugs as risk factors of food anaphylaxis in adults: a case-control study. Bull Acad Nat Med. 2009;193:351-362.
Matsukura S, Aihara M, Sugawara M, et al. Two cases of wheat-dependent anaphylaxis induced by aspirin administration but not by exercise. Clin Exp Dermatol. 2010;35:233-237.
Cardona V, Luengo O, Garriga T, et al. Co-factor-enhanced food allergy. Allergy. 2012;67(10):1316-1318.
Pascal M, Munoz-Cano R, Reina Z, et al. Lipid transfer protein syndrome: clinical pattern, cofactor effect and profile of molecular sensitization to plant-foods and pollens. Clin Exp Allergy. 2012;42:1529-1539.
Nucera E, Di Rienzo A, Ricci AG, Buonomo A, Mazzacappa S, Schiavino D. Adverse reactions to non-steroidal antiinflammatory drugs and hypersensitivity to lipid transfer proteins. Adv Dermatol Allergol. 2016;33:309-310.
Romano A. Possible interaction among hypersensitivity to lipid transfer proteins, chronic urticaria, and hypersensitivity reactions to nonsteroidal anti-inflammatory drugs. Allergy. 2011;43:3-4.
Vidal C, Bartolome B, Gonzalez-Quintela A, Rodriguez V, Armisen M. Prawns, barnacles, and nonsteroidal anti-inflammatory drugs: effect modifiers or diagnostic confounders. J Investig Allergol Clin Immunol. 2007;17(2):113-118.
Matsuo H, Morimoto K, Akaki T, et al. Exercise and aspirin increase levels of circulating gliadin peptides in patients with wheat-dependent exercise-induced anaphylaxis. Clin Exp Allergy. 2005;35:461-466.
Shirai T, Matsui T, Uto T, Chida K, Nakamura H. Nonsteroidal anti-inflammatory drugs enhance allergic reactions in a patient with wheat-induced anaphylaxis. Allergy. 2003;58:1071.
Paul E, Gall HM, Muller I, Moller R. Dramatic augmentation of a food allergy by acetylsalicylic acid. J Allergy Clin immunol. 2000;105:844.
Cant AJ, Gibson P, Dancy M. Food hypersensitivity made life threatening by ingestion of aspirin. Br Med J. 1984;288:755-756.
Mothes-Luksch N, Raith M, Stingl G, et al. Pru p 3, a marker allergen for lipid transfer protein sensitization also in Central Europe. Allergy. 2017;72(9):1415-1418.
Ma S, Nie L, Li H, Wang R, Yin J. Component-Resolved Diagnosis of Peanut Allergy and Its Possible Origins of Sensitization in China. Int Arch Allergy Immunol. 2016;169:241-248.
Murad A, Katelaris CH, Baumgart K. A case study of apple seed and grape allergy with sensitisation to nonspecific lipid transfer protein. Asia Pac Allergy. 2016;6:129-132.
Metz-Favre C, Pauli G, Bessot JC, De Blay F. Molecular allergology in practice: an unusual case of LTP allergy. Allergy. 2011;43:193-195.
Flinterman AE, Akkerdaas JH, den Hartog Jager CF, et al. Lipid transfer protein-linked hazelnut allergy in children from a non-Mediterranean birch-endemic area. J Allergy Clin Immunol. 2008;121:423-428.
Ebo DG, Ahrazem O, Lopez-Torrejon G, Bridts CH, Salcedo G, Stevens WJ. Anaphylaxis from mandarin (Citrus reticulate): identification of potential responsible allergens. Int Ach Allergy Immunol. 2007;144:39-43.
Faber MA, Van Gasse AL, Decuyper II, et al. IgE-reactivity profiles to nonspecific lipid transfer proteins in a northwestern European country. J Allergy Clin Immunol. 2017;139:679-682.
Chen JY, Quirt J, Lee KJ. Proposed new mechanism for food and exercise induced anaphylaxis based on case studies. Allergy Asthma Clin Immunol. 2013;20:9-11.
González-Mancebo E, González-de-Olano D, Trujillo MJ, et al. Prevalence of sensitization to lipid transfer proteins and profilins in a population of 430 patients in the south of Madrid. J Investig Allergol Clin Immunol. 2011;21:278-282.
Scherf KA, Brockow K, Biedermann T, Koehler P, Wieser H. Wheat-dependent exercise-induced anaphylaxis. Clin Exp Allergy. 2016;46:10-20.
Pascal M, Munoz-Cano R, Mila J, et al. Nonsteroidal anti-inflammatory drugs enhance IgE-mediated activation of human basophils in patients with food anaphylaxis dependent on and independent of nonsteroidal anti-inflammatory drugs. Clin Exp Allergy. 2016;46:1111-1119.
Aihara M, Miyazawa M, Osuna H, et al. Food-dependent exercise-induced anaphylaxis: influence of concurrent aspirin administration on skin testing and provocation. British J Dermatol. 2002;146:466-472.
Motomura C, Matsuzaki H, Ono R, et al. Aspirin is an enhancing factor for food-dependent exercise-induced anaphylaxis in children. Clin Exp Allergy. 2017;47:1497-1500.
Doña I, Blanca-López N, Cornejo-García JÁ, et al. Characteristics of subjects experiencing hypersensitivity to Non-steroidal anti-inflammatory drugs: Patterns of response. Clin Exp Allergy. 2011;41:86-95.
Pérez-Sánchez N, Doña I, Bogas G, et al. Evaluation of subjects experiencing allergic reactions to non-steroidal anti-inflammatory drugs: Clinical characteristics and drugs involved. Front Pharmacol. 2020;11:503.
Skypala IJ, Cecchi L, Shamji MH, Scala E, Till S. Lipid Transfer Protein allergy in the United Kingdom: Characterization and comparison with a matched Italian cohort. Allergy. 2019;74(7):1340-1351.
Brockow K, Kneissl D, Valentini L, et al. Using a gluten oral food challenge protocol to improve diagnosis of wheat-dependent exercise-induced anaphylaxis. J Allergy Clin Immunol. 2015;135:977-984.
Kohno K, Matsuo H, Takahashi H, et al. Serum gliadin monitoring extracts patients with negative results in challenge test for the diagnosis of wheat-dependent exercise-induced anaphylaxis. Allegol Intern. 2017;62:229-238.