Hypersensitivity reactions to aspirin and nonsteroid anti-inflammatory drugs

Abstract:

Aspirin (ASA ) and nonsteroid anti-inflammatory drugs (NSAIDs) hypersensitivity manifestations include urticaria, angioedema, asthma, rhinosinusitis, anaphylaxis and a variety of late cutaneous and organ-specific reactions. Pathological mechanisms include the inhibition of cycloxygenase-1 that leads to the shunting of arachidonic acid metabolism towards the 5-lipoxygenase pathway. It results in increased levels of cysteinyl leukotrienes in cross-reactive patients and formation of specific immunoglobulin E antibodies to ASA or a single NSAID. There are also type IV reactions of hypersensitivity. The understanding of the pathological mechanisms is necessary for diagnosis, prevention and management of such reactions. 

Key words:
anti-inflammatory agents, non-steroidal; arachidonic acid; aspirin; drug hypersensitivity