nonsteroidal anti-inflammatory drug hypersensitivity in preschool children非甾体类抗炎药在学龄前儿童过敏症.pdfVIP

ORIGINAL ARTICLE Nonsteroidal Anti-Inflammatory Drug Hypersensitivity in Preschool Children Mona Iancovici Kidon, Liew Woei Kang, Chiang Wen Chin, Lim Siok Hoon, and Van Bever Hugo Although extensively studied in adults, nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity in children, especially in young children, remains poorly defined. Pediatricians, prescribing antipyretics for children, rarely encounter significant problems, but the few epidemiologic studies performed show conflicting results. Although it is clear that some patients with acetylsalicylic acid (ASA)- sensitive asthma have their clinical onset of disease in childhood and bronchoconstriction after ASA challenge is seen in 0 to 22% of asthmatic children so challenged, ibuprofen at antipyretic doses may cause acute respiratory problems only in a very small number of mild to moderate asthmatics. The recently elucidated mechanism of action of acetaminophen may explain some occurrences of adverse reactions in patients with cross-reactive NSAID hypersensitivity on the basis of its inhibitory activity on the newly described enzyme, cyclooxygenase (COX)-3. This nonspecific sensitivity to inhibition of COX is most likely genetically determined and shows a remarkable association with atopic disease even in the very young age group and possibly an increased predilection in specific ethnic groups. This review summarizes state-of-the-art published data on NSAID hypersensitivity in preschool children. Key words: acetaminophen, acetylsalicylic acid (ASA), children, hypersensitivity, ibuprofen, NSAID, preschool A cetylsalicylic acid (ASA) and other nonsteroidal anti- indications for most other NSAIDs in infants and toddlers. inflammatory drugs (NSAIDs) are a group of The only extensively used preparation is ibuprofen, a medications with heterogenic chemica