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KMID : 0882420070720000345
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Korean Journal of Medicine
2007 Volume.72 No. 0 p.345 ~ p.348
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A case of NSAIDs induced anaphylactoid reaction with crossreactivity to celecoxib
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Kim Jeong-Seon
Lee Byoung-Hoon
Lee Eun-Young
Lee Jun-Seok
Shin Sang-Yoon
Kim Sang-Hoon
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Abstract
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For some patients with aspirin intolerance, the administration of aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs) leads to anaphylactoid reactions, and probably through the inhibition of cyclooxygenase (COX)-1. Therefore, cross-reactivity occurs with all NSAIDs that share this COX-1 inhibitory effect. Recent studies have suggested that COX-2 inhibitors can be safely used in patients with aspirin intolerance and who also have documented intolerance to COX-1 inhibitors. Here we report on a case of aspirin intolerance with crossreactivity to celecoxib (Celebrexⓡ), a selective COX-2 inhibitor. A 22-year-old female, who had questionable hypersensivity to some NSAIDs, underwent several allergy tests, including oral provocation tests. The single-blind, placebo-controlled oral challenges with aspirin and celecoxib were all positive. This case confirmed that COX-2 inhibitors are not safe to use in all patients who have aspirin intolerance. It also suggests that other mechanisms may be involved in patients with anaphylactoid reactions to NSAIDs.
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KEYWORD
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Hypersensitivity, Aspirin, Nonsteroidal antiinflammatory drugs, Cyclooxygenase, Celecoxib
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