Published online August 31, 2007
PEDIATRICS Vol. 120 No. 3 September 2007, pp. e742-e744 (doi:10.1542/10.1542/peds.2006-2634)
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EXPERIENCE & REASON

Severe Anaphylactic Reaction to Ibuprofen in a Child With Recurrent Urticaria

Liew Woei Kang, MBBS, MRCPCH, FAMSa, Mona Iancovici Kidon, MDa,b, Chiang Wen Chin, BMedSci, MBBS, MRCPCHa, Lim Siok Hoon, MBBS, MRCPCHa, Chan Yoke Hwee, MBBS, MMedc and Ng Kee Chong, MBBS, MMedd

a Paediatric Allergy, Immunology and Rheumatology Service
c Children's Intensive Care Unit
d Children's Emergency Department, KK Women's and Children's Hospital, Singapore
b Children's Health Centre, Clalit Health Services, Rishon LeZion, Israel

ABSTRACT

An acute anaphylactic reaction after a conventional antipyretic dose of ibuprofen was diagnosed in a child with allergic rhinitis, recurrent idiopathic urticaria, and nonimmunologic cross-reactive hypersensitivity to nonsteroidal antiinflammatory drugs and acetaminophen. The patient reported several previous, mild (isolated cutaneous) hypersensitivity reactions after exposure to acetaminophen or ibuprofen. There was no evidence of an underlying inflammatory disease except as described above. Patients with chronic or recurrent idiopathic urticaria and those with atopic disease represent groups at increased risk of nonsteroidal antiinflammatory drug hypersensitivity. Mild hypersensitivity reactions to acetaminophen and/or ibuprofen may precede subsequent, more-severe adverse reactions. Risks and benefits of continued use of nonsteroidal antiinflammatory drugs in these children should be carefully considered.

Key Words: nonsteroidal antiinflammatory drugs • acetaminophen • ibuprofen • child • allergy • chronic urticaria

Abbreviations: NSAID; nonsteroidal antiinflammatory drug • COX; cyclooxygenase


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