Prevention of nonsteroidal inflammatory drug-induced urticaria and/or angioedema

BackgroundUrticaria and/or angioedema (U/AE) are the most frequent and less severe forms of nonallergic hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs). Management of NSAID-induced U/AE includes (1) the avoidance of the culprit drug and of cyclooxygenase (COX) 1 inhibitors, (2) the use of weak COX-2 inhibitors, and/or (3) desensitization to aspirin. Because these possibilities may have drawbacks, we tested the possibility of preventing NSAID-induced U/AE by the administration of antihistamines and/or a combination of antihistamines and leukotriene antagonists.ObjectiveTo test the preventive effect of antihistamines and/or leukotriene antagonists on the development of U/AE in patients with a history of NSAID hypersensitivity confirmed by a positive challenge result.MethodsA single, placebo-controlled, oral challenge using the culprit NSAID was applied to 65 patients with a history of NSAID-induced U/AE. In the case of recurrence of the symptoms, another oral challenge was performed under premedication with antihistamines alone or combined antihistamines and leukotriene antagonists.ResultsA total of 59 of 65 patients (90%) tolerated a normal dose of NSAID, confirming previous data on the poor reproducibility of nonallergic hypersensitivity reactions to NSAIDs on challenge. Of the 6 patients who experienced recurrence of the U/AE on NSAID challenge, antihistamines and combined antihistamines and leukotriene antagonists prevented the hypersensitivity reactions in 2 and 3 of them, respectively. Only 1 patient still developed a moderate NSAID-induced urticaria despite the double premedication.ConclusionTreatment with NSAIDs at normal doses is possible and well tolerated in patients who have experienced NSAID-induced U/AE, which could be prevented by the concomitant use of antihistamines and leukotriene antagonists.     

珠海室内氡水平及分布特征

目的 通过对珠海市3个典型区域进行调查,探讨不同地质背景区域室内氡浓度的水平和分布.方法 按照地表岩性不同,分为珠海花岗岩、斗门花岗岩和斗门第四纪3个测区,使用活性炭盒累积法进行室内氡浓度测量.在部分测点同时使用活性炭盒累积法和固体径迹法进行室内氡浓度测量.结果 对80间房屋的活性碳盒累积法测量结果显示,珠海平均室内氡浓度为(66.0±49.8) Bq/m3,最大室内氡浓度为1078.5 Bq/m3.测区内23个测点短期活性炭盒累积法的测量结果为(69.5±37.7) Bq/m3,长期固体径迹法的测量结果为(88.8±49.1) Bq/m3.不同地表岩性区域室内氡浓度分别为:珠海花岗岩测区为(73.6±61.0)Bq/m3、斗门花岗岩测区为(87.5±58.3) Bq/m3、斗门第四纪测区为(48.6±22.6) Bq/m3.结论 地表岩性对区域室内氡浓度水平具有明显影响,珠海花岗岩和斗门花岗岩测区室内氡浓度明显高于斗门第四纪测区.建议结合地质背景研究区域室内氡浓度水平与分布特征.