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Paracetamol (acetaminophen) hypersensitivity
B J de Paramo1, S Q Gancedo, M Cuevas
1Allergy Department, Ramon y Cajal Hospital, Madrid, Spain.
Summary
Adverse reactions to acetaminophen (paracetamol) in four patients were investigated. Results suggest an IgE-mediated mechanism, as patients tolerated aspirin but reacted to acetaminophen.
Area of Science:
- Immunology
- Pharmacology
- Allergy
Background:
- Acetaminophen (paracetamol) is a common analgesic antipyretic lacking anti-inflammatory effects.
- Previous reports suggested IgE-mediated reactions to acetaminophen, but evidence was inconclusive.
Purpose of the Study:
- To demonstrate an IgE-mediated mechanism in four patients experiencing adverse reactions to acetaminophen.
- To assess acetaminophen hypersensitivity in patients who tolerate aspirin and other NSAIDs.
Main Methods:
- Four patients with anaphylaxis to acetaminophen and tolerance to NSAIDs were studied.
- Methods included skin testing, oral challenges with acetaminophen and aspirin, and serum IgE testing.
Main Results:
- All patients tolerated aspirin challenges.
- Acetaminophen challenges elicited adverse reactions in all four patients.
- Positive skin tests and detectable IgE antibodies to acetaminophen were observed in two patients.
Conclusions:
- Four cases of adverse reactions to acetaminophen with preserved tolerance to aspirin and NSAIDs are presented.
- Findings suggest an IgE-mediated hypersensitivity mechanism in these acetaminophen reactions.