Menendez R, Venzor J, Ortiz G
Allergy & Asthma Center of El Paso PA, TX 79925, USA.
Ann Allergy Asthma Immunol. 1998 Mar;80(3):225-6. doi: 10.1016/S1081-1206(10)62961-4.
Anaphylaxis to nonsteroidal anti-inflammatory drugs is thought to depend on cycloxygenase inhibition coupled to upregulation of 5-lipoxygenase-dependent pathways. The introduction of leukotriene-receptor antagonists afforded the opportunity to test this hypothesis. These agents provide at least partial protection against aspirin-induced anaphylaxis during controlled challenges but we did not know whether the level of protection was high enough to block symptoms from ingestion of a full dose of aspirin.
We report a patient with moderately severe asthma who experienced an episode of anaphylaxis following ingestion of 400 mg of ibuprofen while under therapy with 20 mg of zafirlukast given twice a day.
No further episodes of anaphylaxis have been noted following institution of complete avoidance to all nonsteroidal anti-inflammatory drugs.
Patients who are sensitive to cycloxygenase inhibitors should practice complete avoidance of these drugs even while under therapy with leukotriene modifiers.
