Increased Total and Mite-Specific Immunoglobulin E in Patients With Aspirin-Induced Urticaria and Angioedema

摘要

Background: An increased prevalence of atopy has been observed in patients with intolerance of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs).Objective: To investigate total and mite-specific immunoglobulin (Ig) E in serum from patients with hypersensitivity to NSAIDs and healthy controls.Methods: Patients who reacted to 2 or more chemically unrelated NSAIDs with urticaria and angioedema, confirmed by a double-blinded provocation test with aspirin, were skin tested with inhalant allergens. Total and specific IgE to Dermatophagoides pteronyssinus (Dp) and Blomia tropicalis (Bt) in the serum was quantified by enzyme-linked immunosorbent assay (ELISA) in patients and a control group of healthyblood donors.Results: One-hundred-and-fourteen patients and 74 controls were studied. Skin tests were positive in 95 patients (83.3%). Total mean IgE levels were 107.1 (91.3) IU/mL in controls and 161.0 (150.8) IU/mL in patients (P=.006). Mean (SD) levels of IgE to Dp were 0.210 (0.17) optical density (OD) units in controls and 0.473 (0.65) OD units in patients (P=.001). Levels of specific IgE to Bt were 0.230 (0.20) OD units in controls and 0.522 (0.8) OD units in patients (P=.0001). Positive ELISA results for IgE to Dp were found for 29.6% of controls and 70.4% of patients (P=.0001); the corresponding percentages for Bt were 32.4% of controls and 67.6 % of patients (P=.0001). Conclusions: Cross-reactive patients with NSAID-induced urticaria and angioedema exhibit an increased prevalence of sensitization to Dp and Bt and increased total serum IgE. Further research is necessary to determine the reasons for this association.Key words: Angioedema. Aspirin. Asthma. Atopy. IgE. NSAID hypersensitivity. Rhinitis. Urticaria.