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