소아에서 비스테로이드항염증제 약물알레르기 4례
Four Cases of Drug Allergy Caused by Non-Steroidal Anti-Inflammatory Drugs in Children
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초록
NSAIDs 약물알레르기는 소아에서 다빈도 약물알레르기로 다른 NSAIDs와의 교차 반응성이 높아 정확한 진단이 필요하다. 저자들은 소아에서 경구유발시험을 통하여 NSAIDs 가성알레르기, ibuprofen 알레르기, acetaminophen 알레르기의 다양한 약물알레르기를 진단하였기에 이를 보고 하는 바이다.
Abstract
Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), which reduce the production of prostaglandin by inhibiting cyclooxygenase (COX), are widely used in children as antipyretic, analgesic, or anti-inflammatory drugs. They are known to be a major cause of pediatric drug allergies, which are diagnosed by a drug provocation test. The mechanism comprises an immunoglobulin E- or T cell-mediated immune reaction or pseudoallergy caused by the inhibition of COX-1. The diagnosis of NSAIDs drug allergy requires a differential, because there is a high cross-reactivity between NSAIDs. In this study, oral provocation tests with ibuprofen, acetaminophen, diclofenac and celecoxib were carried out, and various types of NSAIDs and acetaminophen allergies were observed. Safe drugs were recommended for each patient according to the test results. We report four cases of NSAIDs and acetaminophen allergy and include the results of oral provocation tests.
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