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Severe systemic hypersensitivity reaction to ibuprofen occurring after prolonged therapy
The American Journal of Medicine
|April 1, 1987
Summary
A severe hypersensitivity reaction to ibuprofen, a common pain reliever, occurred in a patient with systemic lupus erythematosus. This case highlights potential diagnostic challenges and delayed-onset drug reactions.
Area of Science:
- Pharmacology
- Immunology
- Rheumatology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
- Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain and inflammation.
- Drug hypersensitivity reactions can occur with NSAIDs, but delayed-onset reactions are less common.
Observation:
- A 23-year-old female with SLE experienced a severe hypersensitivity reaction to ibuprofen.
- The reaction manifested with hypotension, fever, rigors, conjunctivitis, meningitis, nausea, arthralgias, and leukopenia.
- The reaction occurred after two years of uneventful ibuprofen use, suggesting a delayed-onset hypersensitivity.
Findings:
- The hypersensitivity reaction was confirmed by rechallenge.
- The patient's symptoms mimicked an infection or a lupus flare, causing diagnostic confusion.
- Review of literature revealed common features in similar collected cases of ibuprofen hypersensitivity.
Implications:
- This case underscores the importance of considering drug hypersensitivity even after prolonged uneventful use.
- Accurate diagnosis is crucial to differentiate drug reactions from disease flares in SLE patients.
- Clinicians should be aware of the diverse presentations of NSAID-induced hypersensitivity reactions.