Aspirin/ibuprofen
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Reactions 1458 - 29 Jun 2013 S Aspirin/ibuprofen Blended-type sensitivity reaction: case report A 38-year-old man experienced a blended-type aspirin/ NSAID sensitivity reaction while receiving aspirin and ibuprofen [routes not stated]. The man, who had a history of asthma exacerbation, upper respiratory symptoms, and lip swelling after receiving aspirin- containing products, started a desensitization procedure for aspirin-exacerbated respiratory disease (AERD). On day 1, he was administered aspirin 20mg and aspirin 40mg 3 hours later. On day 2, he received aspirin 81mg. Three hours later, he experienced throat itching, urticaria on his upper extremities and chest, a 15% decrease in FEV1, and chest tightness. He was treated with salbutamol, montelukast, and diphenhydramine. His pruritus, urticaria, and spirometry improved. On day 3, he developed urticaria on his hands, legs, and feet, 3 hours after he received aspirin 81mg. He was treated with cetirizine and diphenhydramine and his symptoms improved. He received ibuprofen 50mg on day 4 and developed urticaria on his legs and trunk 3 hours after ibuprofen administration. Zileuton was added to the man’s medication regimen. He received ibuprofen 50mg and then 100mg on day 5 and didn’t experience any reactions. He received ibuprofen 200mg on day 6 and there were no respiratory or cutaneous symptoms. He was discharged receiving ibuprofen 200mg bid and zileuton. At a 6-month follow-up, he asked to stop zileuton. Two days after stopping zileuton, he developed urticaria. His zileuton was restarted and his cutaneous symptoms resolved. At a 1-year follow-up, he had no cutaneous or respiratory symptoms. His final diagnosis was a blended-type aspirin/ NSAID sensitivity reaction. Author comment: "We present a patient with an uncommon reaction to acetylsalicylic acid (ASA) and nonsteroidal anti-inflammatory drugs". Speck AL, et al. Anosmia and an uncommon nonsteroidal anti-inflammatory drug reaction in a 38-year-old man. Allergy and Asthma Proceedings 34: 292-296, No. 3, May-Jun 2013. Available from: URL: http://dx.doi.org/10.2500/ aap.2013.34.3650 - USA 803089052 1 Reactions 29 Jun 2013 No. 1458 0114-9954/10/1458-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Aspirin/ibuprofen
Reactions 1458 - 29 Jun 2013
SAspirin/ibuprofen
Blended-type sensitivity reaction: case reportA 38-year-old man experienced a blended-type aspirin/
NSAID sensitivity reaction while receiving aspirin andibuprofen [routes not stated].
The man, who had a history of asthma exacerbation, upperrespiratory symptoms, and lip swelling after receiving aspirin-containing products, started a desensitization procedure foraspirin-exacerbated respiratory disease (AERD). On day 1, hewas administered aspirin 20mg and aspirin 40mg 3 hourslater. On day 2, he received aspirin 81mg. Three hours later, heexperienced throat itching, urticaria on his upper extremitiesand chest, a 15% decrease in FEV1, and chest tightness. He wastreated with salbutamol, montelukast, and diphenhydramine.His pruritus, urticaria, and spirometry improved. On day 3, hedeveloped urticaria on his hands, legs, and feet, 3 hours afterhe received aspirin 81mg. He was treated with cetirizine anddiphenhydramine and his symptoms improved. He receivedibuprofen 50mg on day 4 and developed urticaria on his legsand trunk 3 hours after ibuprofen administration.
Zileuton was added to the man’s medication regimen. Hereceived ibuprofen 50mg and then 100mg on day 5 and didn’texperience any reactions. He received ibuprofen 200mg onday 6 and there were no respiratory or cutaneous symptoms.He was discharged receiving ibuprofen 200mg bid andzileuton. At a 6-month follow-up, he asked to stop zileuton.Two days after stopping zileuton, he developed urticaria. Hiszileuton was restarted and his cutaneous symptoms resolved.At a 1-year follow-up, he had no cutaneous or respiratorysymptoms. His final diagnosis was a blended-type aspirin/NSAID sensitivity reaction.
Author comment: "We present a patient with anuncommon reaction to acetylsalicylic acid (ASA) andnonsteroidal anti-inflammatory drugs".Speck AL, et al. Anosmia and an uncommon nonsteroidal anti-inflammatory drugreaction in a 38-year-old man. Allergy and Asthma Proceedings 34: 292-296, No.3, May-Jun 2013. Available from: URL: http://dx.doi.org/10.2500/aap.2013.34.3650 - USA 803089052
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Reactions 29 Jun 2013 No. 14580114-9954/10/1458-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
