Non-steroidal antiinflamatuar ilaç alerjisi olan çocukların retrospektif değerlendirilmesi

Özet Amaç: Non-steroidal antiinflamatuar ilaçlar (NSAİİ), sık kullanılan ilaçlar arasındadır ve ilaç ilişkili aşırı duyarlılık reaksiyonları arasında antibiyotiklerden sonra yer almaktadır. Çocuklarda nonsteroid ilaç reaksiyonlarının değerlendirildiği sınırlı sayıda çalışma vardır. Bu çalışmada nonsteroid ilaç reaksiyonu ön tanısı ile gelen ve alerji testleri yapılan çocukların eşlik eden atopik hastalıklar, başvuru kliniği, laboratuvar bulgularının ve ilaç provokasyon testi sonuçlarının retrospektif olarak değerlendirilmesi amaçlandı. Yöntem: Bu çalışmada çocuk alerji polikliniğine nonsteroid ilaç reaksiyonu nedeniyle başvuran hastalar alınmıştır. Bu gruptaki hastalarda yaş, cinsiyet, fx5 ( besin mix spesifik IgE), phadiatop (inhalan alerjen mix spesifik IgE), deri prick testleri ve ilaç provokasyon testleri bilgileri dosyalarından alınarak kaydedildi. Olguların demografik ve klinik özellikleri karşılaştırıldı. Bulgular: NSAİİ allerjisi şüphesi olan 61 hasta çalışmaya dahil edildi. Hastaların başvuru klinikleri değerlendirildiğinde %54 (n:33)’ünün ürtiker, %22.9 (n:14)’unun izole anjioödem, %6.5 (n:4)’ uğunun ürtiker anjioödem, %14.7 (n:9)’sinin ise makülopapüler erupsiyon nedeniyle başvurdukları görüldü. Sadece 1 hasta anafilaksi ile başvurmuştu. Hastaların %16.3 (n:10)’ ünde NSAİİ alerjisi doğrulandı. Hastaların %13. 1(n:8)’inde tekli ibuprofen duyarlılığı tespit edilirken, 1 hastada (%1.6) hem parasetamol hem de ibuprofen duyarlılığı, 1 hastada (%1.6) parasetamol duyarlılığı tespit edildi. Sonuç: Hastalarda ilaç alerjisinin tespit edilmesi genellikle çok kolay olmamaktadır. Bu hastalar sıklıkla yanlış olarak ilaç alerjisi tanısı alabilmektedir. Çalışmamızda NSAİİ alerjisi şüphesi durumunda tanıyı doğrulamak için ilaç provokasyon testlerinin yapılması gerektiği ortaya konulmuştur.

Anahtar Kelimeler:

Non-steroidal antiinflamatuar ilaç alerjisi, izole anjioödem, ilaç provokasyon testi, Non-steroidal antiinflamatuar ilaç alerjisi, izole anjioödem, ilaç provokasyon testi

Retrospective evaluation of children with non-steroidal anti-inflammatory drug allergy

Aim: Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used drugs and are among the drug-related hypersensitivity reactions after antibiotics. There are limited studies evaluating nonsteroidal drug reactions in children. In this study, we aimed to evaluate the concomitant atopic diseases, admission clinic, laboratory findings and drug provocation test results of children with a pre-diagnosis of nonsteroidal drug reaction and who underwent allergy tests, retrospectively . Methods: In this study, patients who applied to the pediatric allergy outpatient clinic due to nonsteroidal drug reaction were included. In this group of patients, age, gender, fx5 (nutrient mix specific IgE), phadiatop (inhalant allergen mix specific IgE), skin prick tests and drug provocation tests were recorded from their files. Demographic and clinical features of the cases were compared. Results: 61 patients with suspected NSAIDs allergy were included in the study. When the admission clinics of the patients were evaluated, 54% (n:33) had urticaria, 22.9% (n:14) had isolated angioedema, 6.5% (n:4) had urticaria angioedema, 14.7% (n:9) had maculopapular eruption . Only 1 patient presented with anaphylaxis. NSAIDs allergy was confirmed in 16.3% (n:10) of the patients.. Single ibuprofen sensitivity was detected in 13.1% of patients (n:8), both paracetamol and ibuprofen sensitivity were detected in 1 patient (1.6%), and single paracetamol sensitivity was detected in 1 patient (1.6%). Conclusions: It is usually not easy to detect drug allergies in patients. These patients may usually misdiagnosed as NSAIDs allergy. In our study, it was revealed that drug provocation tests should be performed to confirm the diagnosis in case of suspected NSAIDs allergy.

Keywords:

Non-steroidal anti-inflammatory drug allergy, isolated angioedema, drug provocation test,

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