Daniel Teitelbaum, Marcus Chiam, and Peter Vadas, MD, PhD; St. Mi- chael's Hospital, Toronto ... icine, Grand Rapids, MI; Spectrum Health, Grand Rapids, MI,.
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Characterization of Patients Reactions to Ibuprofen
with
Allergic
Daniel Teitelbaum, Marcus Chiam, and Peter Vadas, MD, PhD; St. Michael’s Hospital, Toronto, ON, Canada. RATIONALE: Allergic reactions to NSAIDs are amongst the most common causes of reactions to non-prescription medications. Ibuprofen is one of the most commonly used NSAIDs. Herein, we describe a cohort of patients who presented with allergy to ibuprofen. METHODS: Consecutive patients were identified with ibuprofen allergy between 2008-2015 by retrospective chart review. These patients were characterized with respect to demographics, clinical characteristics of their reactions, number of ibuprofen reactions and anaphylaxis severity scores. This study was approved by the institutional REB. RESULTS: 36 patients were identified with allergy to ibuprofen confirmed on history. Females were more commonly affected (25F:11M). The mean age at first reaction was 33 years (range: 5-65). Patients had a mean of 2.31 reactions (range: 1-8) prior to diagnosis. Mean time from to onset was 70.18 minutes (range: 2-540). The mean duration of symptoms was 174.09 minutes (range: 20-690). Most patients had cutaneous involvement (89%); whereas 42% had upper airway and 42% had lower airway involvement. Cardiovascular manifestations were documented in 36% of patients. Anaphylaxis severity scores were calculated. Reactions were mild (grade 1 in 17/36), moderate (grade 2 in 18/36) and severe (grade 3 in 1/36). Co-existent asthma was associated with moderate to severe anaphylaxis to ibuprofen. CONCLUSIONS: Allergic reactions to ibuprofen are one of the most common causes of drug allergy. Patients most commonly affected are young females. Cutaneous involvement is almost always present, but many patients also report cardiopulmonary involvement. Most patients present with mild to moderate reactions, but reactions may be severe, especially in those with co-existent asthma.
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Neuropsychiatric Associations with Drug Allergy
Nicholas L. Hartog, MD1, H. James Wedner, MD, FAAAAI2, and Keerthi Karamched, MD3; 1Michigan State University College of Human Medicine, Grand Rapids, MI; Spectrum Health, Grand Rapids, MI, 2 Washington University School of Medicine, St. Louis, MO, 3University of Michigan, Ann Arbor, MI. RATIONALE: Drug allergy is commonly encountered and previous studies have evaluated various factors that are associated with drug allergy. We hypothesized that in our cohort certain neurological and psychiatric diagnoses would have higher rates of drug allergy/intolerance listed in their chart. METHODS: We examined a cohort of 85 patients who were recruited for a separate study. Charts were reviewed for two years prior to enrollment. Neuropsychiatric diagnoses, drug allergy, and symptoms of drug allergy were based on the patient’s electronic medical record. SPSS was used for statistical analysis. Fisher’s exact test, independent T-test and Chi-squared were used where appropriate. RESULTS: Positive correlation exists between number of psychiatric medications prescribed and number of medication allergies (R50.468; p
