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Anaphylaxis to paracetamol

P A Galindo1, J Borja, P Mur

  • 1Allergy Section, Ciudad Real Hospital Complex, Spain.

Allergologia Et Immunopathologia
|November 17, 1998
PubMed
Summary
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Paracetamol allergy is rare, but this case study shows a patient experiencing anaphylaxis after taking paracetamol. A positive intradermal skin test confirmed paracetamol hypersensitivity, despite negative IgE levels.

Area of Science:

  • Allergy and Immunology
  • Clinical Pharmacology

Background:

  • Anaphylaxis is a severe, potentially life-threatening allergic reaction.
  • Paracetamol (acetaminophen) is a widely used analgesic and antipyretic medication.
  • Drug-induced anaphylaxis necessitates accurate diagnostic approaches.

Observation:

  • A patient presented with recurrent anaphylaxis episodes shortly after ingesting various paracetamol-containing medications.
  • Symptoms included generalized urticaria, dyspnea, wheezing, and intense cough.
  • Diagnostic evaluation involved intradermal skin testing and serum specific IgE measurement.

Findings:

  • Intradermal skin testing with pure paracetamol (100 mg/ml) yielded a positive result in the patient.
  • The same intradermal test was negative in six healthy control subjects.

Related Experiment Videos

  • Serum specific IgE antibodies against paracetamol, measured by radioimmunoassay (RIA), were undetectable.

    • Implications:

    • This case highlights the possibility of paracetamol-induced anaphylaxis, a rare but significant clinical entity.
    • Positive skin tests, though infrequently reported, can be valuable in diagnosing paracetamol hypersensitivity.
    • Clinicians should consider paracetamol allergy in patients with unexplained anaphylaxis, even with negative serological tests.