BACKGROUND: It is known that an intake of non-steroidal anti-inflammatory drugs (NSAIDs) sometimes enhance immediate reactions in patients with food-dependent exercise-induced anaphylaxis (FDEIA). The aim of present study is to evaluate the effects of NSAIDs on food allergy. METHODS: We retrospectively analyzed reports of Japanese patients with immediate-type food allergy enhanced by NSAIDs, published in medical Journals from 1999 to 2008. RESULTS: Forty-seven cases containing 5 cases of food allergy induced by foods without exercise and/or NSAIDs, 33 cases of FDEIA, and 9 cases of food allergy induced by foods with NSAIDs but without exercise (food-dependent salicylate-induced anaphylaxis; FDSIA) were reported. Ages of all patients except those with FDEIA were more than 20 years. Wheat was the most responsible food in all groups (32/47; 68.1%) and gluten-specific IgE was shown by blood examination, and/or skin tests (prick tests and scratch tests) in 12/23 cases (52%). Aspirin enhanced also skin tests in 7 of 8 cases. Many patients had not recognized the enhance effects of NSAIDs on food allergy before performing provocation tests with causative foods and aspirin. CONCLUSION: It was shown that NSAIDs enhance the immediate-type reactions due to food allergy and there are some patients who show allergic reaction only when they take the causative foods, and NSAIDs or salicylate together. Patients with food allergy should avoid NSAIDs ingestion with causative foods because the induced symptoms are serious in some patients.
BACKGROUND: It is known that an intake of non-steroidal anti-inflammatory drugs (NSAIDs) sometimes enhance immediate reactions in patients with food-dependent exercise-induced anaphylaxis (FDEIA). The aim of present study is to evaluate the effects of NSAIDs on food allergy. METHODS: We retrospectively analyzed reports of Japanese patients with immediate-type food allergy enhanced by NSAIDs, published in medical Journals from 1999 to 2008. RESULTS: Forty-seven cases containing 5 cases of food allergy induced by foods without exercise and/or NSAIDs, 33 cases of FDEIA, and 9 cases of food allergy induced by foods with NSAIDs but without exercise (food-dependent salicylate-induced anaphylaxis; FDSIA) were reported. Ages of all patients except those with FDEIA were more than 20 years. Wheat was the most responsible food in all groups (32/47; 68.1%) and gluten-specific IgE was shown by blood examination, and/or skin tests (prick tests and scratch tests) in 12/23 cases (52%). Aspirin enhanced also skin tests in 7 of 8 cases. Many patients had not recognized the enhance effects of NSAIDs on food allergy before performing provocation tests with causative foods and aspirin. CONCLUSION: It was shown that NSAIDs enhance the immediate-type reactions due to food allergy and there are some patients who show allergic reaction only when they take the causative foods, and NSAIDs or salicylate together. Patients with food allergy should avoid NSAIDs ingestion with causative foods because the induced symptoms are serious in some patients.