title: Hypersensitivity to paracetamol in Asian children with early onset of nonsteroidal anti-inflammatory drug allergy.
abstract: BACKGROUND
  The published incidence of paracetamol cross-reactivity in adults and adolescents with nonsteroidal anti-inflammatory drug (NSAID) reactions is low and all data on such reactions in young children is sparse. The study aim was to characterize the clinical presentation and cross-reactivity with paracetamol in patients with a reported onset of NSAID hypersensitivity before 6 years of age.
  
  
  METHODS
  A retrospective case review was done of patients with cross-reactive hypersensitivity reactions to antipyretic/analgesic medications from the pediatric allergy clinic of the Kendang Kerbau Hospital, Singapore. Included patients reported the onset of such reactions before 6 years of age. Hypersensitivity was established through a detailed history of recurrent reactions to NSAIDs or an oral provocation test.
  
  
  RESULTS
  Eighteen patients fulfilled the diagnostic criteria within the study period. Eighty-three percent had cross-reactive reactions with paracetamol. When compared to the group of children with later onset of NSAID hypersensitivity, children with onset before 6 years of age had a significantly increased likelihood of reacting to paracetamol (odds ratio 9.6, 95% confidence interval 1.6-58.0, p < 0.05).
  
  
  CONCLUSIONS
  Paracetamol seems to be a major eliciting drug in this group of children.
authors.affiliation: Rheumatology, Immunology and Allergy Service, Department of Paediatric Medicine, Kendang Kerbau Children's Hospital, Singapore, Singapore. drkidon@yahoo.com
authors.forename: Mona Iancovici
authors.initials: MI
authors.lastname: Kidon
authors.forename: Woei Kang
authors.initials: WK
authors.lastname: Liew
authors.forename: Wen Chin
authors.initials: WC
authors.lastname: Chiang
authors.forename: Siok Hoon
authors.initials: SH
authors.lastname: Lim
authors.forename: Anne
authors.initials: A
authors.lastname: Goh
authors.forename: Jenny Poh Lin
authors.initials: JP
authors.lastname: Tang
authors.forename: Oh Moh
authors.initials: OM
authors.lastname: Chay
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects / Q000276:immunology* / Q000378:metabolism; D000293:Adolescent; D017668:Age of Onset; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000276:immunology*; D001208:Asia; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000453:epidemiology / Q000276:immunology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen