Intolerance to aspirin and the nonsteroidal anti-inflammatory drugs.

A constant enigma has been the ability of aspirin and other structurally unrelated nonsteroidal anti-inflammatory drugs to induce non-IgE mediated allergic reactions. These reactions range from mild hypersensitivity to fatal anaphylaxis. Recent biochemical and pharmacologic studies involving the oxidative metabolism of arachidonic acid in different cells and tissues have provided insights into how this could conceivably occur. The products of cyclo-oxygenase and lipoxygenase pathways of arachidonic acid metabolism and their interactions may provide an approach, if not the solution, to the problem of aspirin intolerance.