Non-steroidal anti-inflammatory drug hypersensitivity: Association with elevated basal serum tryptase?

Cornelia S. Seitz, Knut Brockow, Johannes Hain, Axel Trautmann

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Background: It is hypothesized that because of higher mast cell numbers and mediator release, mastocytosis predisposes patients for systemic immediate-type hypersensitivity reactions to certain drugs including non-steroidal anti-inflammatory drugs (NSAID).Objective: To clarify whether patients with NSAID hypersensitivity show increased basal serum tryptase levels as sign for underlying mast cell disease. Methods: As part of our allergy work-up, basal serum tryptase levels were determined in all patients with a diagnosis of NSAID hypersensitivity and the severity of the reaction was graded. Patients with confirmed IgE-mediated hymenoptera venom allergy served as a comparison group. Results: Out of 284 patients with NSAID hypersensitivity, 26 were identified with basal serum tryptase > 10.0 ng/mL (9.2%). In contrast, significantly (P = .004) more hymenoptera venom allergic patients had elevated tryptase > 10.0 ng/mL (83 out of 484; 17.1%). Basal tryptase > 20.0 ng/mL was indicative for severe anaphylaxis only in venom allergic subjects (29 patients; 4x grade 2 and 25x grade 3 anaphylaxis), but not in NSAID hypersensitive patients (6 patients; 4x grade 1, 2x grade 2). Conclusions: In contrast to hymenoptera venom allergy, NSAID hypersensitivity do not seem to be associated with elevated basal serum tryptase levels and levels > 20 ng/mL were not related to increased severity of the clinical reaction. This suggests that mastocytosis patients may be treated with NSAID without special precautions.

Original languageEnglish
Article number19
JournalAllergy, Asthma and Clinical Immunology
Volume10
Issue number1
DOIs
StatePublished - 24 Apr 2014

Keywords

  • Anaphylaxis
  • Drug allergy
  • Drug reaction
  • Mastocytosis
  • Non-steroidal anti-inflammatory drug
  • Pseudo-allergy

Fingerprint

Dive into the research topics of 'Non-steroidal anti-inflammatory drug hypersensitivity: Association with elevated basal serum tryptase?'. Together they form a unique fingerprint.

Cite this