Hypersensitivity To Nonsteroidal Antiinflammatories: Immediate Selective Reactions to Arylpropionic Acids In A Population In Madrid.
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Marcos Sanchez-Dominguez, Ana Rodriguez-Fernandez, Ines Torrado, Blanca Noguerado-Mellado, Patricia Rojas-Perez-Ezquerra

Allergy reactions due to Nonsteroidal anti-inflammatory drugs (NSAIDs), are one of the main causes of drugs hypersensitivity. The aim of the study was to assess the sensitization profile of immediate reactions to arylpropionic acids in our population.


We performed an observational retrospective study, including all patients attended in our Allergy Unit from May 2008 to October 2016. 1038 patients were revised with suspected selective reactions to NSAIDS.

In 234 an arylpropionic acid was involved, being 179 immediate reactions. Allergy workout included skin tests and oral challenge test (OCT) with the culprit drug.

In all cases we performed an OCT with acetylsalicylic acid (AAS) in order to rule out cross-intolerance.


In 154 out of 179 selective immediate reactions, the offending drug was an arylpropionic acid. 104 women (76.88%), mean age of 50.44 years.

Drugs more frequently involved were ibuprofen in 113 (73.38%), dexketoprofen in 24 (15.58%) and naproxen in 17 (11.04%).

The symptoms were: urticaria 49 (31.82 %), urticaria with angioedema 35 (22.73%), angioedema 27 (17.53%), wheezing 2 (1.3%) and anaphylaxis 41 (26.62%).

Skin test were performed only in 38 (for several causes), all with negative result. In 14, OCT was positive confirming diagnosis. 127 were diagnosed by a suggestive clinical history.

The OCT with AAS was positive only in one case.


The most frequent arylpropionic acid involved was ibuprofen.

The most frequent symptom was urticaria, and anaphylaxis was reported in 26.62%.

The OCT is the gold standard for the diagnosis of immediate selective reactions.