Acetaminophen anaphylaxis with aspirin and sodium salicylate sensitivity: a case report

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
N Schwarz, A Ham Pong

Abstract

Aspirin idiosyncrasy can present with bronchospasm or cutaneous reactions, but combined pulmonary and cutaneous reactions are rare. High-dose acetaminophen has been reported to provoke bronchospasm in aspirin-sensitive asthmatic patients. We report an asthmatic adolescent female who had anaphylaxis with 650 mg acetaminophen after tolerating 325-mg doses for years. She subsequently in sequence had urticaria with aspirin and ibuprofen, and anaphylaxis with sodium salicylate. She was then challenged with acetaminophen, 325 mg orally. Approximately 30 minutes after acetaminophen challenge, she developed rhinoconjunctivitis, urticaria, pruritus, cough, and bronchospasm reversed with antihistamines and bronchodilators. Aspirin sensitivity has not frequently been described in younger age groups. This patient also had several unusual features in that she presented first with sensitivity to acetaminophen that was then followed by aspirin sensitivity. She had urticaria with both aspirin and sodium salicylate; she had combined pulmonary and cutaneous reactions to both acetaminophen and aspirin, which are rarely described; and she had anaphylaxis with low-dose acetaminophen.

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Citations

Sep 26, 2001·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·J A Grant, J M Weiler
Jun 30, 2000·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·D QuaratinoA Venuti
Jan 27, 2009·Journal of Paediatrics and Child Health·Marco Hk HoYu-Lung Lau
Jun 18, 2002·Chest·Cristina Martín-GarcíaAlberto Iscar
Mar 26, 2003·Clinical and Experimental Dermatology·C E H Grattan
Jul 10, 2004·Immunology and Allergy Clinics of North America·Donald D Stevenson
Dec 28, 1999·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·S BavbekZ Misirligil
Jan 9, 2003·Expert Opinion on Pharmacotherapy·Gül Karakaya, A Fuat Kalyoncu
Sep 1, 2004·Expert Opinion on Drug Safety·Eunice K H Tan, Clive E H Grattan
May 7, 2002·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Gülfem CelikZeynep Misirligil

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