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Khandzian M, Hacard F, Braire-Bourrel M, Jaulent C, Bérard F, Nicolas JF, Nosbaum A. [NSAID urticaria: Similar management to acute urticaria]. Rev Med Interne 2019; 40:166-172. [PMID: 30630637 DOI: 10.1016/j.revmed.2018.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 12/03/2018] [Accepted: 12/19/2018] [Indexed: 11/24/2022]
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are the most common providers of immediate hypersensitivity reactions. Among these reactions, isolated acute urticaria is the most common clinical feature with a non-allergic origin. It is a pharmacological side effect resulting from the alteration of arachidonic acid metabolism induced by NSAIDs. Diagnosis of this acute urticaria is clinical, requiring no allergy testing. Currently, the recommended therapeutic management of NSAID urticaria is the avoidance of all NSAID with COX-1 inhibitor activity (even if when reintroduced, they are most often well tolerated) and the use of selective COX-2 inhibitors. This review focuses on urticaria reactions to NSAIDs, which are simple to manage.
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Affiliation(s)
- M Khandzian
- Service d'allergologie et immunologie clinique, hospices civils de Lyon, CHU Lyon-Sud, 69495 Pierre Bénite cedex, France; Université Lyon I, 69007 Lyon, France
| | - F Hacard
- Service d'allergologie et immunologie clinique, hospices civils de Lyon, CHU Lyon-Sud, 69495 Pierre Bénite cedex, France; - CIRI, Centre International de Recherche en Infectiologie, équipe 14, Univ Lyon, Inserm, U111, université Claude-Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, 69007 Lyon, France
| | - M Braire-Bourrel
- Service d'allergologie et immunologie clinique, hospices civils de Lyon, CHU Lyon-Sud, 69495 Pierre Bénite cedex, France
| | - C Jaulent
- Service d'allergologie et immunologie clinique, hospices civils de Lyon, CHU Lyon-Sud, 69495 Pierre Bénite cedex, France
| | - F Bérard
- Service d'allergologie et immunologie clinique, hospices civils de Lyon, CHU Lyon-Sud, 69495 Pierre Bénite cedex, France; Université Lyon I, 69007 Lyon, France; - CIRI, Centre International de Recherche en Infectiologie, équipe 14, Univ Lyon, Inserm, U111, université Claude-Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, 69007 Lyon, France
| | - J-F Nicolas
- Service d'allergologie et immunologie clinique, hospices civils de Lyon, CHU Lyon-Sud, 69495 Pierre Bénite cedex, France; Université Lyon I, 69007 Lyon, France; - CIRI, Centre International de Recherche en Infectiologie, équipe 14, Univ Lyon, Inserm, U111, université Claude-Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, 69007 Lyon, France
| | - A Nosbaum
- Service d'allergologie et immunologie clinique, hospices civils de Lyon, CHU Lyon-Sud, 69495 Pierre Bénite cedex, France; Université Lyon I, 69007 Lyon, France; - CIRI, Centre International de Recherche en Infectiologie, équipe 14, Univ Lyon, Inserm, U111, université Claude-Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, 69007 Lyon, France.
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Serrano C, Guilarte M, Tella R, Dalmau G, Bartra J, Gaig P, Cerdà M, Cardona V, Valero A. Oestrogen-dependent hereditary angio-oedema with normal C1 inhibitor: description of six new cases and review of pathogenic mechanisms and treatment. Allergy 2008; 63:735-41. [PMID: 18070231 DOI: 10.1111/j.1398-9995.2007.01579.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hereditary angio-oedema (HAE) is a rare condition in which there is a deficiency in the quantity or activity of C1 inhibitor (C1INH). Recently, an additional type of HAE with no alterations in the levels or the function of C1INH has been reported. It is defined as HAE with normal C1INH, and named type III HAE or oestrogen-dependent HAE. The aim of this study is to describe the clinical and laboratory findings of six new cases of type III HAE and to review the literature about this disease. METHODS A short description of six women with recurrent angio-oedema is provided. The characteristics of the patients are compared with the previously reported case series in a literature-based review. RESULTS The mean age of the patients at onset was 22 years (range 16-30). All of them had angio-oedema attacks during oestrogen-based contraceptive treatment and four reported episodes during pregnancy. Four patients reported a positive past family history. Two of them had experienced episodes of laryngeal oedema. None of the patients responded to corticoids or antihistamines during the attacks. Levels and functional activity of C1INH were within the normal range in all cases. CONCLUSIONS Clinical and laboratory findings mirror the observations of previous reports of oestrogen-dependent angio-oedema with normal C1INH. This is the first published series of type III HAE in Spain.
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Affiliation(s)
- C Serrano
- Unidad de Alergia, Hospital Clínic, Barcelona, Spain
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