Paracetamol tolerance in children with non-steroidal anti-inflammatory hypersensitivity reactions 
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Anna Paula Marques Mambriz
RATIONALE: Non-steroidal anti-inflammatory drugs (NSAIDs) are present in about one third of pediatric prescriptions, and are the main cause of drug hypersensitivity reactions in Brazil.The aim of this study is to assess paracetamol tolerance in children with NSAID hypersensitivity history and to describe the clinical profile.

METHODS: Methods: Descriptive study was performed in children with suspected hypersensitivity to NSAIDs attended at a specialized clinic between 01/2011 and 01/2017. Clinical records were obtained from a standardized questionnaire.

RESULTS: Results: 140 patients with suspected drug hypersensitivity were evaluated, and in 72 at least one NSAID was involved. 20 patients were excluded with no suggestive history. Hypersensitivity diagnosis was observed in 48 patients, 41 (85.4%) were non-selective and 7 (14.5%) were selective to NSAIDs. Paracetamol was reported as a culprit drug in 22 patients with non-selective reactions, all but one submitted to a drug provocation test (DPT), with just one positive result. Overall, 40 (97,5%) patients with a suspicious non-selective hypersensitivity reaction tolerated paracetamol. A DPT to etoricoxib was performed in 8, aged over 12 years, all with negative results. Other allergic diseases were reported by 35 (72.9%) patients.

CONCLUSIONS: In pediatrics, non-selective reactions to NSAIDs is frequent. Although frequently reported as a causative drug, paracetamol is tolerated by most patients in. The drug provocation test proved to be a safe and useful tool not just for the diagnosis of paracetamol hypersensitivity, but also for evaluating tolerance to alternative drugs like selective COX-2 inhibitors.