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Aspirin and NSAID Reactions: Diagnosis, Pathophysiology, and Management

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Anaphylaxis and Hypersensitivity Reactions

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Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDS) and aspirin are commonly used medications that are not infrequently associated with severe adverse reactions. The approach to the patient with a reaction to a medication in this class can be challenging. Most reactions can be categorized into one of four different types: aspirin/NSAID-induced asthma and rhinitis in asthmatic patients, aspirin/NSAID-induced urticaria/angioedema in patients with chronic urticaria, aspirin/NSAID-induced cross-reacting urticaria in otherwise normal individuals, and single-NSAID-induced reactions in normal subjects. This classification system is useful in planning safe and accurate challenges as well as determining appropriate desensitization protocols. These reactions vary in their pathophysiology, with the role of cyclooxygenase 1, leukotrienes, and prostaglandins remaining dominant.

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  1. Allergy, Asthma and Immunology Department, Scripps Clinic and Scripps Green Hospital, San Diego, CA, USA

    Katharine Woessner

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  1. Andrew A. White
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    Mariana C. Castells

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White, A.A., Laidlaw, T.M., Woessner, K. (2011). Aspirin and NSAID Reactions: Diagnosis, Pathophysiology, and Management. In: Castells, M. (eds) Anaphylaxis and Hypersensitivity Reactions. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-951-2_7

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