Type | Eliciting NSAID | Signs and symptoms | Timing of onset of signs/symptoms | Patient comorbidities |
Pseudoallergic NSAID reactions:
| ||||
Type 1 | Multiple (including aspirin) | Common:
Uncommon:
| Delayed: 30 minutes to 3 hours after ingestion or administration |
|
Type 2 | Multiple (including aspirin) | Urticaria and/or angioedema | 30 to 90 minutes | Chronic urticaria (patients may report being able to tolerate NSAIDs when urticaria is in remission) |
Type 3 | Multiple (including aspirin) | Urticaria and/or angioedema | 30 to 90 minutes | None |
Type 4 | Multiple (including aspirin) | Symptoms affecting both the respiratory tract and skin. Includes patients with AERD who develop cutaneous symptoms in the context of respiratory reactions. | Variable depending upon the type of reaction: 30 to 90 minutes |
|
Allergic NSAID reactions:
| ||||
Type 5 | A single NSAID (not aspirin) | Cutaneous: Urticaria, pruritus, angioedema | Variable: Minutes to a few hours after ingestion/administration | None |
Type 6 | A single NSAID (not aspirin) | Anaphylaxis (probably a more severe form of type 5) | Variable: Minutes to a few hours after ingestion/administration | None |
COX: cyclooxygenase; CT: computed tomography; AERD: aspirin-exacerbated respiratory disease; IgE: immunoglobulin E.
* AERD refers to the triad of asthma, chronic rhinosinusitis with nasal polyposis, and aspirin (or NSAID) induced type 1 pseudoallergic reactions.Do you want to add Medilib to your home screen?