NSAIDs may provoke systemic allergic reactions to bee stings

By Rob Goodier

NEW YORK (Reuters Health) - Non-steroidal anti-inflammatory drugs may provoke systemic allergic reactions to bee stings in people who might otherwise tolerate them, according to a letter published June 27 online in the Annals of Allergy, Asthma and Immunology.

The authors describe three lifelong beekeepers with tolerance to stings who suffered systemic allergic reactions when they were stung shortly after consuming NSAIDs.

After the episodes, all three beekeepers demonstrated tolerance to stings and to NSAIDs when exposed to each separately.

"Taking NSAIDs before attending the beehives may expose to the risk of systemic reactions to honeybee sting," Dr. Cristoforo Incorvaia, an allergy specialist who was involved in the research at ICP Hospital in Milan, Italy, told Reuters Health by email.

Aspirin and ketoprofen were the drugs associated with the systemic reactions in these cases. Because these and similar drugs are commonly prescribed and often available over the counter, NSAIDs might be involved in more bee sting reactions than is known now, the researchers write.

The researchers speculate further that maybe the reaction is associated to the dose of the drug.

"I think that the results are interesting and should be followed up by further studies," said Dr. Stephen Galli in email to Reuters Health. Dr. Galli, Professor of Pathology, Microbiology and Immunology at Stanford School of Medicine in Stanford, California, studies immune system reactions to allergens but was not involved in this research.

If follow-up research bears out these findings, they should have few implications for patients who already have known bee sting allergies, said Dr. Bernadette Eberlein, an allergy specialist at Helmholtz Center for Environmental Health in Munich, Germany.

Those patients are at risk for systemic reactions and should start immunotherapy, Dr. Eberlein added.

SOURCE: http://bit.ly/1o0HFLo

Ann Allergy Asthma Immunol 2014.

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