Ibuprofen and Other Arylpropionic Acid Derivatives Can be Responsible for Immediate Selective Responses to Nsaids.
Monday, March 7, 2016: 3:00 PM
Room 515A (Convention Center)
Diana Perez-Alzate, MD, , , , , , , ,
Rationale: Ibuprofen and other arylpropionic acid derivatives are the most commonly prescribed and consumed NSAIDs worldwide and very often it is available over the counter. Several studies indicate that they are progressivelly involved in hypersensitivity drug reactions that include those mediated by specific immunological mechansims and those classically classified as cross-intolerance reactions. We present a serie of cases with a selective resonse to ibuprofen and other arylpropionic derivatives confirmed by drug provocation tests (DPT).

Methods: Subjects with hypersensitivity reactions to any arylpropionic acid derivatives were included in the study. A DPT was carried out to rule out cross-intolerance (non allergic hypersensitivity). Drug imputability was confirmed by DPT when after drug intake repetitive well defined episodes were reported. Serum tryptase was quantized by immunoassay and in the affected skin by immunohistochemistry and urine N-methyl histamine by immunoassay.

Results: A total of 42 cases were classified as selective immediate responders. Ibuprofen was the drug most frequently involved, followed by naproxen and desketoprofen. Quantitation of tryptase levels in peripheral blood and skin biopsies and N-methyl histamine in urine were indicative of an IgE immediate selective response.

Conclusions: Arylpropionic acid derivatives are responsible for immediate allergic selective responses. Further studies are in progress for identifiyng the possible adducts (hapten-carrier complexes) implicated and the existence of cross-reactivity.