Predictive Value of Autologous Plasma Skin Test for Multiple Nonsteroidal Anti-Inflammatory Drug IntoleranceAsero R.
Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
Background: Recent studies show that patients with multiple nonsteroidal anti-inflammatory drug (NSAID) intolerance are frequently characterized by autoreactivity; this can be detected by autologous serum skin test (ASST). Objective: To assess whether the autologous plasma skin test (APST), a test that was recently shown to be more sensitive than ASST, may be usefully employed as a predictive test for multiple NSAID intolerance in patients with a history of single NSAID intolerance. Methods: Thirty otherwise normal adults with a history of acute urticaria following the ingestion of one single NSAID underwent an APST before being challenged with a COX-1-inhibiting NSAID other than the offending drug. Results: Sixteen patients experienced urticaria following the ingestion of the alternative NSAID and were therefore classified as multiple NSAID reactors; all 16 (100%) scored positive on APST. In contrast only 3/14 patients finally classified as single NSAID reactors were positive on APST (p < 0.001). The positive and negative predictive value of APST for multiple NSAID intolerance were 86 and 100%, respectively. Conclusion: In patients with a history of acute urticaria induced by a single NSAID APST can be usefully employed to detect patients that are prone to react to NSAID other than the original offending one.
© 2007 S. Karger AG, Basel
Received: December 28, 2006
Accepted after revision: March 28, 2007
Published online: June 18, 2007
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 1, Number of References : 32
International Archives of Allergy and Immunology
Vol. 144, No. 3, Year 2007 (Cover Date: October 2007)
Journal Editor: Valenta, R. (Vienna)
ISSN: 1018–2438 (print), 1423–0097 (Online)
For additional information: http://www.karger.com/IAA