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Non-steroidal anti-inflammatory drug hypersensitivity: association with elevated basal serum tryptase?

Please always quote using this URN: urn:nbn:de:bvb:20-opus-110399
  • Background It is hypothesized that because of higher mast cell numbers and mediator release, mastocytosis predisposes patients for systemic immediate-type hypersensitivity reactions to certain drugs including non-steroidal anti-inflammatory drugs (NSAID). Objective To clarify whether patients with NSAID hypersensitivity show increased basal serum tryptase levels as sign for underlying mast cell disease. Methods As part of our allergy work-up, basal serum tryptase levels were determined in all patients with a diagnosis of NSAIDBackground It is hypothesized that because of higher mast cell numbers and mediator release, mastocytosis predisposes patients for systemic immediate-type hypersensitivity reactions to certain drugs including non-steroidal anti-inflammatory drugs (NSAID). Objective To clarify whether patients with NSAID hypersensitivity show increased basal serum tryptase levels as sign for underlying mast cell disease. Methods As part of our allergy work-up, basal serum tryptase levels were determined in all patients with a diagnosis of NSAID hypersensitivity and the severity of the reaction was graded. Patients with confirmed IgE-mediated hymenoptera venom allergy served as a comparison group. Results Out of 284 patients with NSAID hypersensitivity, 26 were identified with basal serum tryptase > 10.0 ng/mL (9.2%). In contrast, significantly (P = .004) more hymenoptera venom allergic patients had elevated tryptase > 10.0 ng/mL (83 out of 484; 17.1%). Basal tryptase > 20.0 ng/mL was indicative for severe anaphylaxis only in venom allergic subjects (29 patients; 4x grade 2 and 25x grade 3 anaphylaxis), but not in NSAID hypersensitive patients (6 patients; 4x grade 1, 2x grade 2). Conclusions In contrast to hymenoptera venom allergy, NSAID hypersensitivity do not seem to be associated with elevated basal serum tryptase levels and levels > 20 ng/mL were not related to increased severity of the clinical reaction. This suggests that mastocytosis patients may be treated with NSAID without special precautions.show moreshow less

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Metadaten
Author: Axel Trautmann, Cornelia S. Seitz, Knut Brockow, Johannes Hain
URN:urn:nbn:de:bvb:20-opus-110399
Document Type:Journal article
Faculties:Fakultät für Mathematik und Informatik / Institut für Mathematik
Medizinische Fakultät / Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie
Language:English
Year of Completion:2014
Source:In: Allergy, Asthma & Clinical Immunology 2014, 10:19. doi:10.1186/1710-1492-10-19
DOI:https://doi.org/10.1186/1710-1492-10-19
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:Anaphylaxis; Drug allergy; Drug reaction; Mastocytosis; Non-steroidal anti-inflammatory drug; Pseudo-allergy
Release Date:2015/03/03
Collections:Open-Access-Publikationsfonds / Förderzeitraum 2014
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung