title: Immediate hypersensitivity reactions to ibuprofen and other arylpropionic acid derivatives.
abstract: Although ibuprofen and other arylpropionic acid derivatives (APs) are the most common medicines involved in hypersensitivity drug reactions (HDRs) to NSAIDs, no patient series studies have been performed regarding immediate selective reactions (SRs) to these drugs.
  
  
  
  To characterize patients with immediate selective HDRs to ibuprofen and other APs through clinical history and challenge.
  
  
  
  Subjects who developed an HDR to APs less than 1 h after drug intake were included. Tolerance to aspirin was assessed and challenge was performed with ibuprofen in all cases, and additionally with the culprit drug (if different) in those patients that tolerated ibuprofen. Serum tryptase levels and tryptase immunohistochemical staining in skin biopsies were also assessed in some patients with a positive DPT to ibuprofen.
  
  
  
  From a total of 245 patients with a confirmed history of HDRs to APs, 17% were classified as selective immediate hypersensitivity reactors by both clinical history and challenge. A selective response to naproxen and dexketoprofen with tolerance to ibuprofen was found in 16 of 20 cases. Significant differences in serum tryptase levels were observed between 2 and 24 h in the 11 cases that were studied further.
  
  
  
  Within the group of patients with HDRs to NSAIDs, APs can induce immediate SRs. Within this group, selective responses to a single drug or responders to several APs may exist, suggesting potential immunological cross-reactivity.
authors: Allergy Service, Infanta Leonor University Hospital, Madrid, Spain.
authors: N
authors: N
authors: Blanca-López
authors: Allergy Service, Infanta Leonor University Hospital, Madrid, Spain.
authors: D
authors: D
authors: Pérez-Alzate
authors: Chemical Technology Institute, UPV-CSIC, Polytechnic University of Valencia, Valencia, Spain.
authors: I
authors: I
authors: Andreu
authors: Allergy Unit, Malaga Regional University Hospital-IBIMA, UMA, Malaga, Spain.
authors: I
authors: I
authors: Doña
authors: Department of Pharmacology, University of Extremadura, Caceres, Spain.
authors: J A
authors: JA
authors: Agúndez
authors: Department of Pharmacology, University of Extremadura, Caceres, Spain.
authors: E
authors: E
authors: García-Martín
authors: Allergy Unit, Malaga Regional University Hospital-IBIMA, UMA, Malaga, Spain.
authors: M
authors: M
authors: Salas
authors: Chemical Technology Institute, UPV-CSIC, Polytechnic University of Valencia, Valencia, Spain.
authors: M Á
authors: MÁ
authors: Miranda
authors: Allergy Unit, Malaga Regional University Hospital-IBIMA, UMA, Malaga, Spain.
authors: M J
authors: MJ
authors: Torres
authors: Allergy Unit, Malaga Regional University Hospital-IBIMA, UMA, Malaga, Spain.|Research Laboratory, IBIMA, Malaga Regional University Hospital, UMA, Malaga, Spain.
authors: J A
authors: JA
authors: Cornejo-García
authors: Allergy Unit, Malaga Regional University Hospital-IBIMA, UMA, Malaga, Spain.
authors: M
authors: M
authors: Blanca
authors: Allergy Service, Infanta Leonor University Hospital, Madrid, Spain.
authors: G
authors: G
authors: Canto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000175:diagnosis / Q000209:etiology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D015415:Biomarkers; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis* / Q000209:etiology*; D007052:Ibuprofen / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012882:Skin Tests; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D007052:Ibuprofen
keywords: arylpropionic acid derivates; ibuprofen; immediate reactions; selective reactions