Serrano C, Valero A, Picado C
Allergy Unit. Hospital Clinic. Barcelona. Spain.
J Investig Allergol Clin Immunol. 2005;15(2):156-7.
Nonsteroidal anti-inflammatory drug (NSAID)-sensitivity is a frequent condition in patients with chronic urticaria and/or asthma. The physiopatologic process underlying respiratory and cutaneous reactions probably involves an increased production of cysteinyl leukotrienes. Cyclooxygenase 2 (COX-2) selective inhibitor, has been proposed as the main alternative to control pain and inflammatory diseases in these patients. However, a small percentage of patients with NSAID-induced skin reactions does not even tolerate COX-2 selective inhibitors. We report a very infrequent case of a patient with NSAID, paracetamol and COX-2 selective inhibitors sensitivity in whom we induced tolerance to paracetamol and celecoxib using the leukotriene receptor antagonist montelukast prior to oral challenges.
非甾体抗炎药（NSAID）敏感性在慢性荨麻疹和/或哮喘患者中是一种常见情况。呼吸和皮肤反应背后的生理病理过程可能涉及半胱氨酰白三烯生成增加。环氧化酶2（COX-2）选择性抑制剂已被提议作为控制这些患者疼痛和炎症性疾病的主要替代药物。然而，一小部分非甾体抗炎药引起皮肤反应的患者甚至不能耐受COX-2选择性抑制剂。我们报告了一例非常罕见的病例，该患者对非甾体抗炎药、对乙酰氨基酚和COX-2选择性抑制剂敏感，我们在口服激发试验前使用白三烯受体拮抗剂孟鲁司特诱导其对乙酰氨基酚和塞来昔布产生耐受性。
