Mathias Cousin1, Anca Chiriac1,2, Nicolas Molinari3, Pascal Demoly1,2, Davide Caimmi4,5. 1. Unité d'allergologie, Département de Pneumologie et Addictologie, Hôpital Arnaud de Villeneuve, CHRU de Montpellier, Montpellier, France. 2. UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Sorbonne Universités, Paris, France. 3. Département de Statistiques, IMAG UMR5149 S, CHRU de Montpellier, Montpellier, France. 4. Unité d'allergologie, Département de Pneumologie et Addictologie, Hôpital Arnaud de Villeneuve, CHRU de Montpellier, Montpellier, France. davide.caimmi@gmail.com. 5. UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Sorbonne Universités, Paris, France. davide.caimmi@gmail.com.
Abstract
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are the main cause of drug-induced hypersensitivity in children. Many classifications have been proposed, focusing on adults. So far, no large study has deeply investigated a pediatric cohort. The aim of the present study was to describe a population of NSAID hypersensitive patients reporting a reaction during their childhood and to verify whether it is possible to classify pediatric patients, following the EAACI/ENDA classification. METHODS: We conducted a historical prospective study including patients evaluated from 1996 to 2015 in the allergy unit of the Montpellier University Hospital. We included 635 patients. For each patient, we recorded clinical manifestations and possible comorbidities and tried to identify possible risk factors. RESULTS: NSAID hypersensitivity was diagnosed in 107 of 635 patients (16.9%). In this group, 43 patients (40.2%) could not be classified following the ENDA recommendations. The main discrepancies were on the patients' clinical manifestations and on their possible underlying diseases. We identified, on a multivariate analysis, some risk factors for NSAID hypersensitivity: chronic urticaria (OR 7.737, 3.375-18.296 95%CI), atopic status (OR 2.514, 1.504-4.364 95%CI), and allergic rhinoconjunctivitis (OR 1.799, 1.138-2.837 95%CI). On the basis of our results, we are proposing an adapted classification for NSAID hypersensitivity in children. CONCLUSIONS: The current ENDA classification does not seem to be adapted for pediatric patients; a modified version does. Our study could help allergists better understand the differences between adults and children in developing hypersensitivity reactions to NSAIDs, but further large-scale prospective longitudinal analyses are required to validate this new classification.
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are the main cause of drug-induced hypersensitivity inchildren. Many classifications have been proposed, focusing on adults. So far, no large study has deeply investigated a pediatric cohort. The aim of the present study was to describe a population of NSAID hypersensitivepatients reporting a reaction during their childhood and to verify whether it is possible to classify pediatric patients, following the EAACI/ENDA classification. METHODS: We conducted a historical prospective study including patients evaluated from 1996 to 2015 in the allergy unit of the Montpellier University Hospital. We included 635 patients. For each patient, we recorded clinical manifestations and possible comorbidities and tried to identify possible risk factors. RESULTS: NSAID hypersensitivity was diagnosed in 107 of 635 patients (16.9%). In this group, 43 patients (40.2%) could not be classified following the ENDA recommendations. The main discrepancies were on the patients' clinical manifestations and on their possible underlying diseases. We identified, on a multivariate analysis, some risk factors for NSAID hypersensitivity: chronic urticaria (OR 7.737, 3.375-18.296 95%CI), atopic status (OR 2.514, 1.504-4.364 95%CI), and allergic rhinoconjunctivitis (OR 1.799, 1.138-2.837 95%CI). On the basis of our results, we are proposing an adapted classification for NSAID hypersensitivity inchildren. CONCLUSIONS: The current ENDA classification does not seem to be adapted for pediatric patients; a modified version does. Our study could help allergists better understand the differences between adults and children in developing hypersensitivity reactions to NSAIDs, but further large-scale prospective longitudinal analyses are required to validate this new classification.
Authors: Inmaculada Doña; Esther Barrionuevo; María Salas; José Julio Laguna; José Agúndez; Elena García-Martín; Gádor Bogas; James Richard Perkins; José Antonio Cornejo-García; María José Torres Journal: Sci Rep Date: 2018-11-12 Impact factor: 4.379
Authors: Natalia Pérez-Sánchez; Inmaculada Doña; Gador Bogas; María Salas; Almudena Testera; José A Cornejo-García; María J Torres Journal: Front Pharmacol Date: 2020-04-21 Impact factor: 5.810
Authors: Claudio Cravidi; Silvia Caimmi; Maria De Filippo; Alberto Martelli; Carlo Caffarelli; Michele Miraglia Del Giudice; Mauro Calvani; Maria Angela Tosca; Fabio Cardinale; Gian Luigi Marseglia; Sara Manti; Elena Chiappini; Davide Caimmi Journal: Acta Biomed Date: 2020-09-15