Hypersensitivity to paracetamol in Asian children with early onset of nonsteroidal anti-inflammatory drug allergy.
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.
Kidon
Mona Iancovici
MI
Rheumatology, Immunology and Allergy Service, Department of Paediatric Medicine, Kendang Kerbau Children's Hospital, Singapore, Singapore. drkidon@yahoo.com
Liew
Woei Kang
WK
Chiang
Wen Chin
WC
Lim
Siok Hoon
SH
Goh
Anne
A
Tang
Jenny Poh Lin
JP
Chay
Oh Moh
OM
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
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen