Hypersensitivity to paracetamol in Asian children with early onset of nonsteroidal anti-inflammatory drug allergy

Mona Iancovici Kidon, Woei Kang Liew, Wen Chin Chiang, Siok Hoon Lim, Anne Goh, Jenny Poh Lin Tang, Oh Moh Chay
International Archives of Allergy and Immunology 2007, 144 (1): 51-6

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.

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