Pediatr Allergy Respir Dis.  2011 Dec;21(4):344-349.

Four Cases of Drug Allergy Caused by Non-Steroidal Anti-Inflammatory Drugs in Children

• Park GM
• Seo JH
• Kim HY
• Yu J
• Hong SJ

Abstract

Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), which reduce the production of prostaglandin by inhibiting cyclooxygenase (COX), are widely used in children as antipyretic, analgesic, or anti-inflammatory drugs. They are known to be a major cause of pediatric drug allergies, which are diagnosed by a drug provocation test. The mechanism comprises an immunoglobulin E- or T cell-mediated immune reaction or pseudoallergy caused by the inhibition of COX-1. The diagnosis of NSAIDs drug allergy requires a differential, because there is a high cross-reactivity between NSAIDs. In this study, oral provocation tests with ibuprofen, acetaminophen, diclofenac and celecoxib were carried out, and various types of NSAIDs and acetaminophen allergies were observed. Safe drugs were recommended for each patient according to the test results. We report four cases of NSAIDs and acetaminophen allergy and include the results of oral provocation tests.

Keyword

Non-steroidal anti-inflammatory agents; Allergy; Drug hypersensitivity; Oral provocation test

MeSH Terms

Acetaminophen
Anti-Inflammatory Agents, Non-Steroidal
Child
Diclofenac
Drug Hypersensitivity
Humans
Hypersensitivity
Ibuprofen
Immunoglobulins
Prostaglandin-Endoperoxide Synthases
Pyrazoles
Sulfonamides
Celecoxib
Acetaminophen
Anti-Inflammatory Agents, Non-Steroidal
Diclofenac
Ibuprofen
Immunoglobulins
Prostaglandin-Endoperoxide Synthases
Pyrazoles
Sulfonamides

Figure

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  Fig. 1. The figures show urticaria after oral provocation test of acetaminophen on the face (A), back (B) and neck (C).

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  Fig. 2. Urticaria on the leg (A) and swollen fingers (B) after acetaminophen provocation test, urticaria on bottom after ibuprofen provocation test (C).

Reference

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