Nonsteroidal anti-inflammatory drug hypersensitivity in a pediatric severe asthmatic population.
Nonsteroidal anti-inflammatory drug hypersensitivity in a pediatric severe asthmatic population.
复制标题
儿童严重哮喘人群中的非甾体抗炎药过敏。
DOI：
10.1002/ppul.26618
复制
发表时间：
2023
影响因子：
3.1
通讯作者：
Kloepfer,KirstenM
中科院分区：
文献类型：
--
作者：
Hadley,Abigail;Slaven,JamesE;Krupp,NadiaL;Kloepfer,KirstenM
哮喘是一种儿科常见病。识别加重因素对于获得更好的哮喘控制很重要。一个潜在的加重诱因是NSAID-hypersensitivity （NSAID-H）。关于儿童非甾体抗炎药- h的研究有不同的人口统计、方法和结论。然而，大多数研究发现非甾体抗炎药- h在哮喘患者中更为普遍。方法目的是确定儿童重度哮喘人群中NSAID-H的患病率、症状和相关因素。2020年11月至2022年5月期间，来自印第安纳州印第安纳波利斯Riley儿童医院严重哮喘诊所的100名6至18岁儿童完成了一项关于哮喘诱因、过敏、合并症诊断、鼻窦症状和非甾体抗炎药反应史的调查。结果19%的参与者报告对至少一种非甾体抗炎药有反应。布洛芬（16%）、阿司匹林（9%）和对乙酰氨基酚（9%）是影响最大的非甾体抗炎药。最常见的症状是30分钟内出现呼吸困难、喘息、咳嗽、头晕和腹痛。相关因素包括非甾体抗炎药引发哮喘（p = 0.02）、鼻息肉（p = 0.01）、衰老（p = 0.01）、感冒诱发哮喘（p = 0.02）和直系亲属慢性鼻窦炎（p = 0.04）。结论某大型儿童医院小儿重症哮喘门诊非甾体抗炎药- h的患病率为19%。最常见的药物是布洛芬，最常见的症状是呼吸道和胃肠道。相关因素包括药物和感冒引发的哮喘、鼻息肉、耳聋和慢性鼻窦炎家族史。这强调了对可能有较高NSAID-H风险的严重哮喘患者进行全面病史的重要性。未来的研究应该集中在观察NSAID-H在更大的严重哮喘人群中的发生率，以及健康的社会决定因素是否在反应发生率增加中起作用。
IntroductionAsthma is a common pediatric disease. Identification of exacerbating factors is important to gain better asthma control. One potential exacerbation trigger is NSAID-hypersensitivity (NSAID-H). Studies regarding pediatric NSAID-H have varied demographics, methodologies, and conclusions. However, most studies find NSAID-H more prevalent in asthmatic patients.MethodsThe objective was to determine the prevalence, symptoms, and factors associated with NSAID-H in a pediatric severe asthma population. One hundred children aged 6 to 18 years old from the Severe Asthma Clinic at Riley Hospital for Children in Indianapolis, IN, between 11/2020 and 5/2022 completed a survey about asthma triggers, allergies, co-morbid diagnoses, sinus symptoms, and NSAID reaction history.ResultsNineteen percent of participants reported a reaction to at least one NSAID. Ibuprofen (16%), aspirin (9%), and acetaminophen (9%) were the most implicated NSAIDs. Most common symptoms were dyspnea, wheezing, coughing, lightheadedness, and abdominal pain appearing within 30 minutes. Associated factors included history of a medication other than an NSAID triggering asthma (p = 0.02), nasal polyps (p = 0.01), ageusia (p = 0.01), cold-induced asthma (p = 0.02), and chronic sinusitis in immediate family member (p = 0.04).ConclusionsPrevalence of NSAID-H in a large children’s hospital pediatric severe asthma clinic was 19%. The most common drug was ibuprofen and the most common symptoms were respiratory and gastrointestinal. Associated factors included medication and cold triggered asthma, nasal polyps, ageusia, and family history of chronic sinusitis. This highlights the importance of a thorough history in severe asthma patients who may be at higher risk for NSAID-H. Future studies should focus on looking at the rate of NSAID-H in a larger severe asthma population and if social determinants of health play a role in the increased incidence of reacting.