NSAID intolerance in chronic idiopathic urticaria: A study of its relationship with histamine-releasing activity of patients’ sera

Abstract

in patients with CIU intolerance to NSAID does not depend on the mechanism of histamine release.

Multiple NSAID Intolerance in Chronic Idiopathic Urticaria Is Correlated with Delayed, Pronounced and Prolonged Autoreactivity

“…Our results in a case population from Turkey revealed a lower incidence (38.2%) of autoreactivity in CIU when compared to those of the previous studies from other countries (2, 8–10, 13, 14, 16). However, the positivity of ASST in NSAID intolerant CIU patients ( i.e.…”

“…It also remains to be explained which mechanisms underlie the increased LT 4 de novo production after ASST in patients with severe CIU (14). A putative mechanism for NSAID‐induced exacerbation in CIU has been proposed to be an increased activity of LTC 4 synthase (2), which is a key enzyme for the production of cysteinyl leukotrienes, because a fivefold increase in LTC 4 synthase positive cells has been shown in the majority of the patients with aspirin‐induced asthma (18). On the other hand, some anecdotal case reports (19–23) and study results (24, 25) have shown that LT receptor antagonists montelukast and zafirlukast were effective in the treatment of CIU, particularly in the control of severe urticaria/angioedema exacerbations related to cold, pressure, food additives, and NSAIDs.…”

“…It is well known that a rather high proportion (up to 60%) of patients with CIU have an autoreactivity, because they show a whealand-flare reaction upon intradermal autologous serum injection (1,2,8,9). Skin reactivity to autologous sera is also associated with higher urticaria activity, i.e., a higher frequency of daily symptoms and concurrent angioedema, and it usually disappears during remissions (1,11).…”

“…Chronic idiopathic urticaria (CIU) is a common form of urticaria defined as erythematous wheals with or without angioedema occurring daily or at least three days a week for more than six weeks (1). It is well known that a considerable proportion (21 to 30%) of patients with CIU are intolerant of acetyl salicylic acid (ASA) and a number of chemically unrelated non‐steroidal anti‐inflammatory drugs (NSAIDs) (2, 3). Cross‐reactivity among NSAIDs is usually seen in patients with CIU, but also in otherwise healthy persons.…”

EAACI/GA2LEN task force consensus report: the autologous serum skin test in urticaria

“…The prevalence of NSAIDs intolerance seems to be similar in ASST + and ASST − patients with CU (65). However, a high proportion (91–93%) of patients presenting with new onset urticaria after the ingestion of several chemically unrelated drugs have a positive ASST (16, 17).…”