Hypersensitivity to antipyretics: pathogenesis, diagnosis, and management.

Hypersensitivity to antipyretics: pathogenesis, diagnosis, and management. Hong Kong Med J. 2017 Jul 07;: Authors: Lee QU Abstract Antipyretics are commonly prescribed drugs and hypersensitivity occurs at rates of 0.01% to 0.3%. Hypersensitivity can be due to immune mechanisms that include type I to IV hypersensitivity. Type I hypersensitivity results from specific immunoglobulin E production following sensitisation on first exposure. Subsequent exposures elicit degranulation of mast cells, culminating an immediate reaction. Non-type I hypersensitivity is a delayed reaction that involves various effector cells, resulting in maculopapular rash, fixed drug eruptions, drug reaction with eosinophilia and systemic symptoms, and Stevens-Johnson syndrome/toxic epidermal necrolysis. Antipyretics also cause non-immune hypersensitivity via cyclooxygenase inhibition. Apart from hypersensitivity to parent compounds, hypersensitivity to excipient has been reported. Clinical manifestations of antipyretic hypersensitivity involve the skin, mucosa, or multiple organs. Diagnosis of hypersensitivity requires a detailed history taking and knowledge of any underlying disorders. Differential diagnoses include infection, inflammatory conditions, and antipyretics acting as co-factors of other allergens. Investigations include specific immunoglobulin E assays, lymphocyte transformation test, basophil activation test, and skin prick test. Lack of standardisa...
Source: Hong Kong Med J - Category: General Medicine Authors: Tags: Hong Kong Med J Source Type: research