Strong, Immediate-Type Skin-Test Responses to Blomia tropicalis in Nonsteroidal Anti-Inflammatory Drug-Sensitive Subjects with Urticaria and Angioedema

摘要

Background: Patients with sensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) of the cutaneous pattern (urticaria and angioedema) frequently have concomitant atopic disease and immediate-type skin responses to inhalant allergens. This study compared skin-test reactivity to domestic mites in subjects who develop urticaria and angioedema after exposure to NSAIDs with such responses in atopic non-NSAID-sensitive individuals. Methods/Data base: In patients with urticaria and angioedema NSAID, hypersensitivity was demonstrated by means of double-blind, placebo-controlled oral challenge. Prick skin tests with allergenic extracts from Dermatophagoides pteronyssinus (Dp) and Blomia tropicalis (Bt) were applied to NSAID-sensitive and control patients with atopic rhinitis, asthma or eczema. According to drugs eliciting the reactions, drug hypersensitive patients were classified as single-reactors (SR) or cross-reactors (CR). Results: Two hundred atopic control subjects and 96 NSAID-sensitive patients (78 CR and 18 SR) were studied. Mean wheal diameters for Dp were: Controls 6.97±3.5 mm, SR 7.83±2.8 mm (p n.s.), and CR 7.85±3.1 mm (p n.s.). For Bt diameters were: Controls 5.7±3.5 mm, SR 7.33±3.3 mm (p n.s.), and CR 9.0±4.3 mm (p = .00001). Conclusions: Cross-reactive NSAID-sensitive subjects with urticaria and angioedema show stronger allergic responses to allergens from Blomia tropicalis than single-reactor subjects and atopic non-NSAID-sensitive patients.