Severe anaphylactic reaction to ibuprofen in a child with recurrent urticaria.
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.
Kang
Liew Woei
LW
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
Kidon
Mona Iancovici
MI
Chin
Chiang Wen
CW
Hoon
Lim Siok
LS
Hwee
Chan Yoke
CY
Chong
Ng Kee
NK
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*
D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D007052:Ibuprofen