Nonsteroidal anti-inflammatory drugs-induced hypersensitivity reactions Algorithm for the diagnostic and management

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Andrei Gheorghe Vicovan
Liliana Veres
Andrei Cucu
Dana Turliuc
Cristina Mihaela Ghiciuc

Abstract

The role of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in neurosurgical practice is a secondary one, however they are still constantly involved in perioperative management of pain or in nonoperative management of acute radiculopathy. Beside the well-known adverse reactions (ADRs), the neurosurgeon practitioner should also take in account the drug hypersensitivity reactions (DHRs) of NSAIDs and be able to deal with it. The aim of this paper was to review the diagnostic and management steps for NSAIDs-induced Hypersensitivity Reactions. The actual stratification of NSAIDs-induced Hypersensitivity Reactions is based on understanding of the heterogeneity of immunological/non-immunological mechanisms of reactions and complexity of clinical manifestations. Practically, this stratification allows the physician to assess suspicion of DHR, based on anamnesis and clinical analysis, and to consider further practical steps to manage and eventually confirm the diagnosis. Drug allergies are considered only the DHRs for which a definite immunological mechanism (either drug-specific antibody or T cell) is demonstrated. In conclusion, clinical analysis and anamnesis of patient with NSAIDs-induced Hypersensitivity Reactions can be realized by any physician and could be enough to diagnose, but it is not sufficient to confirm the diagnosis. In vitro tests and oral provocation challenges may be necessary to be undertaken by an allergy specialist.

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How to Cite
Vicovan, A., Veres, L., Cucu, A., Turliuc, D., & Ghiciuc, C. (2019). Nonsteroidal anti-inflammatory drugs-induced hypersensitivity reactions. Romanian Neurosurgery, 33(4), 411-416. https://doi.org/10.33962/roneuro-2019-066
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Articles
Author Biographies

Andrei Gheorghe Vicovan

1. "Grigore T. Popa" University of Medicine and Pharmacy Iași, Romania

2. "Sfântul Spiridon" Emergency Clinical Hospital Iași, Romania

Liliana Veres

1. "Grigore T. Popa" University of Medicine and Pharmacy Iași, Romania

2. "Sfântul Spiridon" Emergency Clinical Hospital Iași, Romania

Andrei Cucu

"Prof. Dr. N. Oblu" Emergency Clinical Hospital Iași, Romania

Dana Turliuc

"Prof. Dr. N. Oblu" Emergency Clinical Hospital Iași, Romania

Cristina Mihaela Ghiciuc

"Grigore T. Popa" University of Medicine and Pharmacy Iași, Romania