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Related Experiment Videos

Selective adverse reactions to diflunisal

J Arias1, M Fernández-Rivas, A Moral

  • 1Allergy Section, Hospital Virgen del Valle, Toledo, Spain.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|February 1, 1995
PubMed
Summary

Two patients experienced immediate allergic reactions to diflunisal, a nonsteroidal anti-inflammatory drug. They tolerated other NSAIDs and salicylates, suggesting a selective adverse reaction mechanism.

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Area of Science:

  • Pharmacology
  • Immunology
  • Clinical Medicine

Background:

  • Diflunisal, a difluorophenyl derivative of salicylic acid, is used for pain relief.
  • Adverse reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) can range from mild to severe.

Observation:

  • Two patients presented with immediate adverse reactions, including generalized urticaria and chest tightness, after taking diflunisal.
  • Standard allergy tests, including skin prick tests, intradermal tests, and radioallergosorbent assays (RAST), were negative for diflunisal.
  • Leukocyte histamine release tests also did not indicate an allergic response to diflunisal.

Findings:

  • Patients tolerated therapeutic doses of aspirin, salsalate, salicylamide, lysine acetylsalicylate, acetaminophen, dipyrone, and propyfenazone.

Related Experiment Videos

  • Oral provocation with diflunisal triggered an immediate reaction in both patients at a cumulative dose of 400 mg.
  • These cases demonstrate selective adverse reactions to diflunisal, with no cross-reactivity to other salicylates or NSAIDs.

    • Implications:

    • The mechanism of these selective adverse reactions to diflunisal is unclear and may be idiosyncratic or immunologic.
    • Inhibition of cyclooxygenase (COX) is unlikely to be the primary mechanism involved in these reactions.
    • Further research is needed to elucidate the specific pathogenic pathways underlying diflunisal hypersensitivity.