Rydzyńska Magdalena, Lis Kinga, Bartuzi Zbigniew, Rosada Tomasz, Grześk-Kaczyńska Magdalena, Ukleja-Sokołowska Natalia
Clinic of Allergology, Clinical Immunology and Internal Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, Ujejskiego 75, 85-168 Bydgoszcz, Poland.
Department of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland.
Int J Mol Sci. 2025 Jun 22;26(13):5988. doi: 10.3390/ijms26135988.
Non-steroidal anti-inflammatory drugs (NSAIDs) can cause hypersensitivity reactions and lead to anaphylactic shock. These drugs also act as cofactors in allergic reactions. Lipid transfer proteins (LTPs), found in plants, represent a unique group of allergens in which cofactors play a crucial role. This case report describes a 26-year-old female who developed anaphylactic symptoms after ingesting grapes and taking ketoprofen. The patient experienced swelling of the lips, tongue, and throat, as well as shortness of breath, dizziness, and loss of consciousness, after consuming grapes and taking ketoprofen. She had previously used ketoprofen and acetylsalicylic acid without issues but had developed urticaria on several occasions after consuming multi-ingredient dishes. Skin prick tests showed positive results for peanut and orange allergens. Further testing using the ALEX multiparametric test detected antibodies to several LTP allergens. Intradermal tests with ketoprofen yielded a positive result, although irritant reactions could not be ruled out. A provocation test with acetylsalicylic acid (ASA) showed no adverse reactions. Skin tests with ibuprofen were negative, and provocation tests confirmed its tolerance. A diagnosis of LTP allergy and selective ketoprofen allergy was made, with the recommendation to avoid ketoprofen and follow a diet excluding foods from the LTP group.
非甾体抗炎药（NSAIDs）可引起过敏反应并导致过敏性休克。这些药物在过敏反应中也起辅助因子的作用。植物中发现的脂质转移蛋白（LTPs）是一类独特的过敏原，其中辅助因子起着关键作用。本病例报告描述了一名26岁女性，在食用葡萄并服用酮洛芬后出现过敏症状。该患者在食用葡萄并服用酮洛芬后出现嘴唇、舌头和喉咙肿胀，以及呼吸急促、头晕和意识丧失。她之前使用酮洛芬和乙酰水杨酸没有问题，但在食用多成分菜肴后曾多次出现荨麻疹。皮肤点刺试验显示对花生和橙子过敏原呈阳性结果。使用ALEX多参数检测进一步检测到针对几种LTP过敏原的抗体。酮洛芬皮内试验呈阳性结果，尽管不能排除刺激性反应。乙酰水杨酸（ASA）激发试验未显示不良反应。布洛芬皮肤试验为阴性，激发试验证实其耐受性良好。诊断为LTP过敏和选择性酮洛芬过敏，建议避免使用酮洛芬，并遵循排除LTP组食物的饮食。
