BACKGROUND: The published incidence of paracetamol cross-reactivity in adults and adolescents with nonsteroidal anti-inflammatory drug (NSAID) reactions is low and all data on such reactions in young children is sparse. The study aim was to characterize the clinical presentation and cross-reactivity with paracetamol in patients with a reported onset of NSAID hypersensitivity before 6 years of age. METHODS: A retrospective case review was done of patients with cross-reactive hypersensitivity reactions to antipyretic/analgesic medications from the pediatric allergy clinic of the Kendang Kerbau Hospital, Singapore. Included patients reported the onset of such reactions before 6 years of age. Hypersensitivity was established through a detailed history of recurrent reactions to NSAIDs or an oral provocation test. RESULTS: Eighteen patients fulfilled the diagnostic criteria within the study period. Eighty-three percent had cross-reactive reactions with paracetamol. When compared to the group of children with later onset of NSAID hypersensitivity, children with onset before 6 years of age had a significantly increased likelihood of reacting to paracetamol (odds ratio 9.6, 95% confidence interval 1.6-58.0, p < 0.05). CONCLUSION: Paracetamol seems to be a major eliciting drug in this group of children.
BACKGROUND: The published incidence of paracetamol cross-reactivity in adults and adolescents with nonsteroidal anti-inflammatory drug (NSAID) reactions is low and all data on such reactions in young children is sparse. The study aim was to characterize the clinical presentation and cross-reactivity with paracetamol in patients with a reported onset of NSAID hypersensitivity before 6 years of age. METHODS: A retrospective case review was done of patients with cross-reactive hypersensitivity reactions to antipyretic/analgesic medications from the pediatric allergy clinic of the Kendang Kerbau Hospital, Singapore. Included patients reported the onset of such reactions before 6 years of age. Hypersensitivity was established through a detailed history of recurrent reactions to NSAIDs or an oral provocation test. RESULTS: Eighteen patients fulfilled the diagnostic criteria within the study period. Eighty-three percent had cross-reactive reactions with paracetamol. When compared to the group of children with later onset of NSAID hypersensitivity,children with onset before 6 years of age had a significantly increased likelihood of reacting to paracetamol (odds ratio 9.6, 95% confidence interval 1.6-58.0, p < 0.05). CONCLUSION:Paracetamol seems to be a major eliciting drug in this group of children.
Authors: Bernard Yu-Hor Thong; Michaela Lucas; Hye-Ryun Kang; Yoon-Seok Chang; Philip Hei Li; Min Moon Tang; James Yun; Jie Shen Fok; Byung-Keun Kim; Mizuho Nagao; Iris Rengganis; Yi-Giien Tsai; Wen-Hung Chung; Masao Yamaguchi; Ticha Rerkpattanapipat; Wasu Kamchaisatian; Ting Fan Leung; Ho Joo Yoon; Luo Zhang; Amir Hamzah Abdul Latiff; Takao Fujisawa; Francis Thien; Mariana C Castells; Pascal Demoly; Jiu-Yao Wang; Ruby Pawankar Journal: Asia Pac Allergy Date: 2020-01-30