Mechanism of aspirin-induced urticaria not exactly the same as Samter's

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Note that this study was performed on patients with NSAID-induced skin symptoms alone, and without asthma. It would ahve been interesting to see the results on patients with both.-----------Arerugi. 2011 Jun 30;60(6):699-707.[ANALYSIS OF 76 PATIENTS WITH URTICARIA AND ANGIOEDEMA INDUCED BY NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) IN JAPAN.][Article in Japanese]Moriya M, Aihara M, Hirota R, Hirata Y, Ikinaga N, Takamura N, Kunimi Y, Uchida T, Ikezawa Z.SourceDepartment of Dermatology, Yokohama City University School of Medicine, Yokohama, Japan.AbstractBackground: The pathogenesis of urticaria and angioedema induced by non-steroidal anti-inflammatory drugs (NSAIDs) is still obscure. We analyzed the clinical characteristics of patients with NSAIDs-induced urticaria and angioedema without asthma in Japan. Methods: We retrospectively collected the cases of NSAIDs-induced urticaria and angioedema from Japanese medical journals in 2000-2009. Results: Seventy-six patients were analyzed. The male/female ratio was 1:2.5 and the mean age was 38.1 years. Urticaria was most frequent clinical manifestation in 3 groups; urticaria alone, urticaria and angioedema, and angioedema alone. Time interval from drug administration to onset was 5 minutes to 48 hours by aspirin at a dose of 25-1000 mg. Skin prick test was performed with aspirin in 33 patients, and the results were negative in all patients. Meloxicam, a selective cyclooxygenase-2 (COX-2) inhibitor, and celecoxib, a new selective COX-2 inhibitor, were administered safely in 4 of 6 patients and in 2 of 3 patients with NSAIDs-induced urticaria, respectively. These drugs were administered safely in all administered patients with NSAIDs-induced angioedema. Tiaramidehydrochroride (a basic COX-1 inhibitor) was safely used in 23 administered patients with NSAIDs-induced angioedema. Leukotriene receptor antagonists were effective in 2 of 5 patients administered, but aggravated symptoms in the others. Conclusion: Diversity of NSAIDs-induced urticaria and angioedema was shown in this study. Pathogenesis of NSAIDs-induced urticaria and angioedema without asthma seems to be different from that of NSAIDs-induced asthma.