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ARTIGO DE REVISÃO

Hypersensitivity to nonsteroidal

anti-inflammatory drugs:

From pathogenesis to clinical practice

Hipersensibilidade a anti-inflamatórios não esteroides:

Da patogénese à prática clínica

Data de receção / Received in: 28/10/2017
Data de aceitação / Accepted for publication in: 17/11/2017

Re v P or t Im unoalerg ologia 2018; 26 (3): 207-220

Inês Mota, Ângela Gaspar, Mário Morais-Almeida
Imunoallergy Department, CUF Descobertas Hospital, Lisbon

ABSTRACT

Nonsteroidal anti -inflammatory drugs (NSAIDs) are one of the leading causes of hypersensitivity reactions, which affect a
considerable percentage of the general population. These drugs can induce a wide spectrum of reactions with distinct timing,
organ involvement and severity, including either immunological or nonimmunological mechanisms. A proper diagnosis can be
particularly challenging since most reactions result from the pharmacological mechanism of the drug and might be dose -dependent.
The clinical classification of NSAIDs -induced reactions has changed over time. Accurate diagnosis depends on strict clinical
history and proper understanding of underlying mechanism. Skin testing and in vitro testing have limited usefulness. Drug chal-
lenge tests with the culprit or alternative drugs are the gold standard for the diagnosis, and provide information about drug
avoidance and safe therapeutic options. In selected cases drug desensitization might be a therapeutic option. In this review, we
will attempt to highlight the main aspects to be taken into account for a proper management of patients with NSAIDs hyper-
sensitivity.

Key -words: Acetylsalicylate acid, alternative drugs, desensitization, diagnosis, hypersensitivity, nonsteroidal anti -inflammatory
drugs.

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REVIST A POR TUGUESA DE IMUNO ALERGOLOGIA