title: Selective anaphylaxis to paracetamol in a child.
abstract: Paracetamol anaphylaxis is a very rare event, with only a few cases described in literature and even less reported in children. We report the case of a 15-year-old boy, referred to Immunoallergy Department due to four reproducible episodes of anaphylaxis after paracetamol administration, since the age of 8 years. The most severe episode occurred at 12 years, characterized by glottis edema with respiratory distress, hypotension, generalized urticaria and facial edema, immediately after intravenous administration of paracetamol during a post-operatory recovery. He had always and still tolerates ibuprofen; an oral challenge test with meloxicam was negative. Skin prick and intradermal tests with paracetamol were negative. Serum-specific IgE and CAST to paracetamol were also negative. This report provides an alert to health-care professionals regarding the potential severity of reactions occurring within the therapeutic range of this widely used drug.
authors.affiliation: Immunoallergy Department, CUF-Descobertas Hospital, Lisbon, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Couto
authors.forename: A
authors.initials: A
authors.lastname: Gaspar
authors.forename: M
authors.initials: M
authors.lastname: Morais-Almeida
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects*; D000293:Adolescent; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D000707:Anaphylaxis / Q000139:chemically induced*; D004342:Drug Hypersensitivity / Q000209:etiology*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen; D007073:Immunoglobulin E