Recurrent sulindac-induced aseptic meningitis in a patient tolerant to other nonsteroidal anti-inflammatory drugs.

The association of nonsteroidal anti-inflammatory drugs (NSAIDs) and recurrent aseptic meningitis has been only rarely noted in patients without underlying connective tissue disease. I have described a patient who had four episodes of unexplained meningitis for which no auto-inflammatory or infectious cause could be found. Three of the episodes were found to have been immediately preceded by sulindac doses. The patient has tolerated aspirin, indomethacin, naproxyn, fenoprofen, diflunisal, and ibuprofen before and since this association was noted, implying an immunologic hypersensitivity to sulindac and not a pharmacologic effect of the entire class of such drugs.