Anaphylactoid reactions are not mediated by IgE, but they have symptoms and time courses that mimic allergic reactions. NSAIDs are a major cause of anaphylactoid reactions. NSAIDs such as aspirin alter the arachidonic acid pathway and increase asthmatic response. Pulmonary hyperactivity induced by aspirin and otherNSAIDs is not mediated by IgE reactivity. These patients manifest a cyclooxygenase blockade of arachidonic acid metabolism leading to preferential production of leukotrienes from the lipoxygenase pathway (Burrell et al., 1992).
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