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Paracetamol (acetaminophen) hypersensitivity

C Vidal¹, C Pérez-Carral, A González-Quintela

¹Division of Allergy, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology

|November 14, 1997

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Hypersensitivity to paracetamol (acetaminophen) is rare, but this case shows a severe allergic reaction. The patient tolerated aspirin, suggesting a specific paracetamol allergy mechanism.

Area of Science:

Clinical immunology
Pharmacology

Background:

Paracetamol (acetaminophen) intolerance is uncommon, typically seen in aspirin-sensitive individuals due to prostaglandin synthesis inhibition.
Hypersensitivity to paracetamol without aspirin sensitivity is rare.

Observation:

A case of a life-threatening hypersensitivity reaction to paracetamol is presented.
An oral challenge with 125 mg of paracetamol induced a generalized anaphylactic reaction.

Findings:

The patient tolerated a 500 mg oral aspirin challenge, indicating no cross-reactivity or aspirin sensitivity.
The reaction suggests a true allergic mechanism to paracetamol, distinct from prostaglandin inhibition.

Implications:

This case highlights the possibility of specific paracetamol allergy.

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It underscores the importance of considering non-prostaglandin-mediated hypersensitivity in paracetamol reactions.