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Allergy, Asthma & Clinical Immunology
Published in: Allergy, Asthma & Clinical Immunology 1/2014

Open Access 01-12-2014 | Research

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

Authors: Cornelia S Seitz, Knut Brockow, Johannes Hain, Axel Trautmann

Published in: Allergy, Asthma & Clinical Immunology | Issue 1/2014

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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.
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Metadata
Title
Non-steroidal anti-inflammatory drug hypersensitivity: association with elevated basal serum tryptase?
Authors
Cornelia S Seitz
Knut Brockow
Johannes Hain
Axel Trautmann
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Allergy, Asthma & Clinical Immunology / Issue 1/2014
Electronic ISSN: 1710-1492
DOI
https://doi.org/10.1186/1710-1492-10-19

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