Perfil dos pacientes com urticária e angioedema por anti-inflamatórios não esteroidais do Serviço de Alergia e Imunologia do Hospital do Servidor Público do Estado de São Paulo
Profile of patients with urticaria and angioedema caused by nonsteroidal anti-inflammatory drugs in the Allergy and Immunology Division of Hospital do Servidor Público Estadual de São Paulo
Priscila Bechaalani; Veridiana Aun-Pereira; Andrea Pescadinha de Carvalho; Wilson Tartuce Aun; João Ferreira de Mello
Resumo
Objetivos: Identificar pacientes com história de urticária e angioedema desencadeados por anti-inflamatórios não esteroidais (AINEs), no Serviço de Alergia e Imunologia do Hospital do Servidor Público Estadual de São Paulo, classificá-los como seletivos e não seletivos e avaliar a tolerabilidade ao inibidor de COX-2 (etoricoxib 90 mg). Métodos: Os indivíduos com múltiplas reações desencadeadas por AINE, de grupos diferentes, foram submetidos a teste de provocação oral com Etoricoxib 90 mg. Pacientes com história de urticária e/ou angioedema a um único grupo de AINE, ou com primeiro episódio, realizaram testes de provocação oral com outro grupo de AINE, para classificá-los em seletivo ou não. Resultados: Estudou-se 43 pacientes, com idade entre 18 e 71 anos, predomínio do sexo feminino (77%). A maioria dos pacientes apresentavam reações a múltiplos AINE (não seletivos) e 2 (5%) a um único AINEs (seletivos). Observou-se sintomas alérgicos em 53%, com predomínio da rinite (61%). Os fármacos mais implicados foram: dipirona (39%), diclofenaco (18%) e AAS (14%). Todos os pacientes apresentaram teste com etoricoxib 90 mg negativo. Conclusão: A maioria dos pacientes apresentou reação não seletiva, e todos os pacientes apresentaram teste com etoricoxib 90 mg negativo, demonstrando segurança e ser uma boa opção terapêutica.
Palavras-chave
Abstract
Objectives: To identify patients with a history of urticaria and angioedema caused by nonsteroidal anti-inflammatory drugs (NSAIDs) at the Allergy and Immunology Division of Hospital do Servidor Público Estadual de São Paulo, to classify them as selective or nonselective, and to evaluate their tolerability to cyclooxygenase-2 inhibitors (etoricoxib 90 mg). Methods: Patients with multiple reactions induced by NSAIDs, from different groups, were subjected to oral provocation test with etoricoxib 90 mg. Patients with a history of urticaria and/or angioedema induced by only one group of NSAIDs, or experiencing their first episode, were subjected to oral provocation test with another NSAID group to classify them as selective or non-selective. Results: A total of 43 patients aged 18-71 years, predominantly female (77%), were studied. The majority of patients showed reactions to multiple NSAIDs (non-selective); only 2 (4.6%) reacted to only one NSAID (selective). Allergic symptoms were observed in 53% of the patients, mainly rhinitis (61%). The drugs most frequently involved were dipyrone (39%), diclofenac (18%) and acetylsalicylic acid (14%). The etoricoxib 90 mg test resulted negative for all patients. Conclusion: The majority of patients showed nonselective reactions, and all of them showed negative etoricoxib 90 mg tests, demonstrating the safety and appropriateness of this treatment option.
Keywords
References
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Submitted date:
04/19/2017
Accepted date:
05/03/2017
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