title: Severe anaphylactic reaction to ibuprofen in a child with recurrent urticaria.
abstract: An acute anaphylactic reaction after a conventional antipyretic dose of ibuprofen was diagnosed in a child with allergic rhinitis, recurrent idiopathic urticaria, and nonimmunologic cross-reactive hypersensitivity to nonsteroidal antiinflammatory drugs and acetaminophen. The patient reported several previous, mild (isolated cutaneous) hypersensitivity reactions after exposure to acetaminophen or ibuprofen. There was no evidence of an underlying inflammatory disease except as described above. Patients with chronic or recurrent idiopathic urticaria and those with atopic disease represent groups at increased risk of nonsteroidal antiinflammatory drug hypersensitivity. Mild hypersensitivity reactions to acetaminophen and/or ibuprofen may precede subsequent, more-severe adverse reactions. Risks and benefits of continued use of nonsteroidal antiinflammatory drugs in these children should be carefully considered.
authors.affiliation: Paediatric Allergy, Immunology and Rheumatology Service, KK Women's and Children's Hospital, 100 Bukit Timah Rd, Singapore 229899. liew.woei.kang@kkh.com.sg
authors.forename: Liew Woei
authors.initials: LW
authors.lastname: Kang
authors.forename: Mona Iancovici
authors.initials: MI
authors.lastname: Kidon
authors.forename: Chiang Wen
authors.initials: CW
authors.lastname: Chin
authors.forename: Lim Siok
authors.initials: LS
authors.lastname: Hoon
authors.forename: Chan Yoke
authors.initials: CY
authors.lastname: Hwee
authors.forename: Ng Kee
authors.initials: NK
authors.lastname: Chong
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects; D000707:Anaphylaxis / Q000139:chemically induced*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D004342:Drug Hypersensitivity / Q000209:etiology; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D012008:Recurrence; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications; D014581:Urticaria / Q000150:complications*
chemical_list: D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D007052:Ibuprofen