scholarly journals A case of delayed maculopapular eruption to ibuprofen and acute urticaria to acetaminophen

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110564
Author(s):  
Jason Wong ◽  
Ashley Sandoval ◽  
Tiffany Jean ◽  
Asal Gharib Naderi
Keyword(s):  
Immunoglobulin E ◽  
Maculopapular Rash ◽  
Initial Therapy ◽  
Cross Reactivity ◽  
Delayed Reaction ◽  
Acute Urticaria ◽  
Maculopapular Eruption ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Delayed Hypersensitivity Reaction

We present the unique case of a 33-year-old male referred to our clinic in search of analgesic options who was found to have a delayed hypersensitivity reaction to ibuprofen manifesting as a maculopapular rash and acute urticaria to acetaminophen. Non-steroidal anti-inflammatory drugs are associated with predictable reactions as well as immunoglobulin E-mediated reactions or T-cell mediated reactions. This case highlights the importance of knowledge of the different types of reactions to non-steroidal anti-inflammatory agents as well as the risk of cross reactivity. Delayed reaction to a single non-steroidal agent is rare; urticaria to acetaminophen is very rare. This is the first report we have found in the literature where one individual has a delayed reaction manifesting as rash to ibuprofen as well as urticaria to acetaminophen. We challenged our patient to aspirin which helped identify that his delayed reaction was only to ibuprofen and urticaria only to acetaminophen. The case also highlights the importance of an oral provocation challenge when no contraindications exist which helped us find that he could take celecoxib and avoid narcotics as initial therapy.

scholarly journals AB0273 HYPERSENSIVITY REACTIONS TO NON STEROID ANTI INFLAMMATORY DRUGS: A BOUT 87 CASES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1162.3-1162
Author(s):  
K. Ksouda ◽  
R. Sahnoun ◽  
R. Atheymen ◽  
I. Bouaziz ◽  
A. Hanène ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Tiaprofenic Acid ◽  
Maculopapular Rash ◽  
Cross Reactivity ◽  
Hypersensitivity Reactions ◽  
Fixed Drug Eruption ◽  
Cross Reactions ◽  
Immunological Mechanisms ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Background:Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the leading causes of hypersensitivity reactions to drugs. The pathogenesis may be immunological mechanisms (allergic reactions) or non specific immunological reactions often incriminated in cross reactivity independently of chemical structure of these molecules. Understanding of the underlying mechanism is necessary for prevention and choice of safe alternatives [1, 2].Objectives:Analyze all cases of non-steroidal anti-inflammatory drugs cutaneous eruption reported to sfax pharmacovigilance service since January 2015 to December 2020 and evaluate the possibility of cross-reactions between different molecules in this class.Methods:We conducted a retrospective study of all cases reported to sfax pharmacovigilance department. An enquiry of pharmacovigilance was performed in patients who presented side effects to AINS. The imputability study was carried out by the French method of Imputability. Medical history specifies if there is a re-administration to assess tolerance and cross-reactivity.Results:Our study included 87 patients whose average age was 45, 8 years. The sex ratio (F/M) was 1.18. lysine salicylate acetyl is the most incriminated (31%), then mefenamic acid (19.5%), diclofenac (19.5 %), ketoprofen in (9.2%), piroxicam in (6.9 %), ibuprofen in (5.4%), celocoxib in (3.4%), tiaprofenic acid in (1.1%) and naproxen in 1.1% of cases. The most common skin injury was urticaria in 29 cases (33.3%). Fixed drug eruption was observed in 17 cases. Maculopapular rash was observed in 19 cases, anaphylaxis in 5 cases and 4 cases of photosensitivity were observed. In our study we found cross-reactivity between (NSAIDs) in 8 patients.Conclusion:The diagnostic approach is often based on the controlled administration of the drug to assess tolerance and to identify safe alternatives. In cases of intolerance to COX 1 inhibitors, cross-reactions to selective cox 2 inhibitors are very rare [3].References:[1]Inmaculada Dona, Maria Salas, James R Perkins and al. Hypersensitivity Reactions to Non-Steroidal Anti-Inflammatory Drugs. Curr Pharm Des 2016; 22(45):6784-6802.[2]Flavia Angeletti, Franziska Meier, Nadja Zöller, Markus Meissner, Roland Kaufmann, Eva Maria Valesky. Hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAIDs) - a retrospective study. J Dtsch Dermatol Ges 2020 Dec; 18(12):1405-1414.[3]N Blanca-López, J A Cornejo-García, M C Plaza-Serón, and al. Hypersensitivity to Nonsteroidal Anti-inflammatory Drugs in Children and Adolescents: Cross-Intolerance Reactions. J Investig Allergol Clin Immunol 2015; 25(4):259-69.Disclosure of Interests:None declared

Association of thromboxane A1 synthase (TBXAS1) gene polymorphism with acute urticaria induced by nonsteroidal anti-inflammatory drugs

2013 ◽  
Vol 132 (4) ◽  
pp. 989-991 ◽  
Author(s):  
Carmen Vidal ◽  
Liliana Porras-Hurtado ◽  
Raquel Cruz ◽  
Joaquín Quiralte ◽  
Victoria Cardona ◽  
...  
Keyword(s):  
Gene Polymorphism ◽  
Acute Urticaria ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Pharmacotherapy of Juvenile Idiopathic Arthritis

2008 ◽  
Vol 22 (1) ◽  
pp. 17-28 ◽  
Author(s):  
Edward A. Bell
Keyword(s):  
Clinical Trials ◽  
Juvenile Idiopathic Arthritis ◽  
Initial Therapy ◽  
Biologic Agents ◽  
Rheumatic Disorder ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Therapy Methotrexate

Juvenile idiopathic arthritis is the most common rheumatic disorder of childhood, and is defined as arthritis beginning prior to the age of 16 years, lasting more than 6 weeks, with an unknown cause. Seven subtypes of juvenile idiopathic arthritis have recently been categorized and named. These subtypes differ broadly in the number of affected joints and the presence of systemic illness. Although many children with juvenile idiopathic arthritis may achieve remission prior to entering adulthood, many others will continue to have debilitating disease into adulthood. Pharmacotherapy plays a major role in the treatment of juvenile idiopathic arthritis. Nonsteroidal anti-inflammatory drugs and corticosteroids can be beneficial for many children and are used as initial therapy. Methotrexate may offer benefits to children unresponsive to these initial agents. Studies evaluating the use of several biologic agents and immunosuppressants have recently been published, and the role of these drugs for children with juvenile idiopathic arthritis is being assessed. Major clinical trials and pediatric implications are reviewed.

scholarly journals Cytosolic Phospholipase A2 (PLA2G4A) Polymorphisms Associated with Acute Urticaria/angioedema Induced by Nonsteroidal Anti-inflammatory Drugs

2021 ◽  
Vol 147 (2) ◽  
pp. AB14
Author(s):  
Raquel Jurado Escobar ◽  
Jose Triano-Cornejo ◽  
Inmaculada Doña ◽  
Natalia Pérez Sánchez ◽  
Gador Bogas Herrera ◽  
...  
Keyword(s):  
Phospholipase A2 ◽  
Cytosolic Phospholipase A2 ◽  
Acute Urticaria ◽  
Cytosolic Phospholipase ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Variants of CEP68 Gene Are Associated with Acute Urticaria/Angioedema Induced by Multiple Non-Steroidal Anti-Inflammatory Drugs

PLoS ONE ◽  
2014 ◽  
Vol 9 (3) ◽  
pp. e90966 ◽  
Author(s):  
José Antonio Cornejo-García ◽  
Carlos Flores ◽  
María C. Plaza-Serón ◽  
Marialbert Acosta-Herrera ◽  
Natalia Blanca-López ◽  
...  
Keyword(s):  
Acute Urticaria ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Maculopapular delayed exanthema due to ranitidine

2020 ◽  
Vol 4 (1) ◽  
pp. 014-016
Author(s):  
Alfonso Pilar Hernández ◽  
Mahave Idoia González ◽  
Oribe Irene Vidal ◽  
del Pozo Gil Mª Dolores ◽  
Díaz Mónica Venturini ◽  
...  
Keyword(s):  
Patch Testing ◽  
Oral Treatment ◽  
Cross Reactivity ◽  
Receptor Antagonists ◽  
H2 Receptor Antagonists ◽  
Delayed Reaction ◽  
H2 Receptor ◽  
Systemic Involvement ◽  
Maculopapular Eruption ◽  
Special Cases

Ranitidine is a widely used drug in Europe and its intake is usually well tolerated. Hypersensitivity reactions due to ranitidine are uncommon. The immediate mild reactions type are the most prevalent. In some special cases a delayed type reaction such as contact dermatitis or severe reactions with systemic involvement have been reported. In the present paper, a case report of a 78-year old patient who experienced a maculopapular eruption after 7 days of oral treatment with ranitidine is described. Patch tests were performed twice with ranitidine with positive results confirming the diagnosis. In order to discard a double sensitization and a possible cross-reactivity phenomenon, patch test was performed once with famotidine, with a negative result. This is the first maculopapular exanthema reported as type IV hypersensitivity reaction to ranitidine confirmed by patch testing. Moreover, there are only two reported cases showing a double sensitization to ranitidine and to other H2-receptor antagonists by patch testing after a delayed reaction due to ranitidine, the other being H2-receptor antagonists involving cimetidine and nizatidine, not famotidine.

scholarly journals Analysis of Treatment-Related Factors Affecting Mortality in Patients with Severe Necrotizing Acute Pancreatitis

2016 ◽  
Vol 33 (3) ◽  
pp. 173-185
Author(s):  
Ivan Praznik ◽  
Marko Spasić ◽  
Ivan Radosavljević ◽  
Bojan Stojanović ◽  
Dragan Čanović ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Importance ◽  
Initial Therapy ◽  
Protective Role ◽  
Retrospective Case ◽  
Related Factors ◽  
Early Introduction ◽  
Risk Of Death ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Summary The aim of the paper was to determine the factors related to the initial therapy that may contribute to death from severe necrotizing acute pancreatitis and to analyze their clinical importance as well as possible additive effects. A retrospective case-control study included all adult patients treated for severe necrotizing acute pancreatitis in the Clinical Center of Kragujevac, Serbia, during the five-year period (2006-2010.). The cases (n = 41) were patients who died, while the controls (n = 69) were participants who survived. In order to estimate the relationship between potential risk factors and observed outcome, crude and adjusted odds ratios (OR) with 95 % confidence intervals (CI) were calculated in logistic regression models. Significant association with observed outcome was shown for the use of gelatin and/or hydroxyethyl starch (adjusted OR 12.555; 95 % CI 1.150-137.005), use of albumin (adjusted OR 27.973; 95 % CI 1.741-449.373), use of octreotide (adjusted OR 16.069; 95 % CI 1.072-240.821) and avoiding of enteral feeding (adjusted OR 3.933; 95 % CI 1.118-13.829), while the use of nonsteroidal anti-inflammatory drugs had protective role (adjusted OR 0.057; 95 % CI 0.004-0.805). The risk of death in patients with predicted severe necrotizing acute pancreatitis could be reduced with avoidance of treatment with colloid solutions, albumin and octreotide, as well as with an early introduction of oral/enteral nutrition and use of nonsteroidal anti-inflammatory drugs.

scholarly journals Experience of using a systemic glucocorticosteroid as an initial therapy for post-COVID-19 arthritis in outpatient practice

2021 ◽  
Vol 5 (5) ◽  
pp. 252-256
Author(s):  
V.E. Yershov ◽  
◽  
A.V. Krivova ◽  
V.P. Zakharov ◽  
S.V. Bystrov ◽  
...  
Keyword(s):  
Reactive Arthritis ◽  
Initial Therapy ◽  
Transmitted Infection ◽  
Dose Administration ◽  
Number Of Patients ◽  
Inflammatory Drugs ◽  
Coronavirus Infection ◽  
Anti Inflammatory ◽  
Outpatient Practice ◽  
Russian Medical

ABSTRACT Amid the COVID-19 pandemic, a large number of patients with joint lesions resistant to nonsteroidal anti-inflammatory drugs (NSAIDs) was encountered in our clinical practice. The article summarizes the positive experience of outpatient therapy of 916 patients (mean age 47.1±11.3 years), including 774 women, with arthritis of various localization, which occurred on average 45.0±7.1 days after a previously transmitted infection caused by SARS-CoV-2. 709 (77.4%) patients used NSAIDs before going to the clinic, the effect of which was absent or insufficient. In this regard, intramuscular injections of betamethasone prescribed to 823 patients were used as the initial therapy (considering the comorbid background and allergy history). During the drug intake, most of the patients had relief of inflammation, pain reduction, improvement of the disease segment function already on the 7th day. In 69.3% of cases, a single-dose administration was sufficient. The obtained results allow drawing preliminary conclusions about the feasibility of using this technique in the complex treatment of reactive arthritis after the SARS-CoV-2 infection. KEYWORDS: coronavirus infection, COVID-19, glucocorticosteroids, nonsteroidal anti-inflammatory drugs, reactive arthritis. FOR CITATION: Yershov V.E., Krivova A.V., Zakharov V.P., Bystrov S.V. Experience of using a systemic glucocorticosteroid as an initial therapy for post-COVID-19 arthritis in outpatient practice. Russian Medical Inquiry. 2021;5(5):252–256 (in Russ.). DOI: 10.32364/2587- 6821-2021-5-5-252-256.

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