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Recurrent ibuprofen-induced aseptic meningitis

Huy T V Nguyen1, David N Juurlink

  • 1Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada.

The Annals of Pharmacotherapy
|January 27, 2004
PubMed
Abstract

Insights

Recurrent aseptic meningitis was linked to ibuprofen use in a patient. Discontinuing the nonsteroidal anti-inflammatory drug (NSAID) resolved symptoms, highlighting NSAIDs as potential causes.

Area of Science:

  • Neurology
  • Pharmacology
  • Immunology

Background:

  • Aseptic meningitis is a rare condition often associated with drug therapy.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently implicated in drug-induced aseptic meningitis.
  • Rechallenge with the suspected NSAID is uncommon in reported cases.

Observation:

  • A 51-year-old man experienced recurrent episodes of confusion and aphasia.
  • Symptoms began shortly after taking nonprescription ibuprofen and resolved upon discontinuation.
  • Cerebral imaging was normal, and infectious causes were ruled out via lumbar puncture, which showed lymphocytic pleocytosis.

Findings:

  • The patient's recurrent symptoms were strongly correlated with ibuprofen use.
  • An objective causality assessment indicated a probable link between ibuprofen and aseptic meningitis.
  • This case highlights the potential for NSAIDs, particularly ibuprofen, to induce aseptic meningitis.

Implications:

  • Clinicians should consider NSAIDs, including ibuprofen, in the differential diagnosis of recurrent aseptic meningitis.
  • A thorough medication history, especially of nonprescription drugs, is crucial for diagnosis.
  • Early recognition and discontinuation of the offending NSAID can lead to prompt symptom resolution.

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