Prevalence of cross-sensitivity with acetaminophen in aspirin-sensitive asthmatic subjects

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Objective: Cross-sensitivity between aspirin and acetaminophen in aspirin-sensitive asthmatic patients has been reported with frequencies ranging from 0% to 29%. The relationship is dose-dependent for acetaminophen challenges, ranging between 300 and 1000 mg. Methods: To determine the prevalence of cross-sensitivity to high-dose acetaminophen, we performed single-blind acetaminophen oral challenges with 1000 mg and 1500 mg in 50 aspirin-sensitive asthmatic patients and in 20 non-aspirin-sensitive asthmatic control subjects. Results: Overall, 17 of 50 (34%) of aspirin-sensitive asthmatic patients reacted to acetaminophen in doses of 1000 to 1500 mg (95% confidence interval: 20% to 49%). By contrast, none of the 20 non-aspirin-sensitive asthmatic patients reacted to acetaminophen (95% confidence interval: 0% to 14%). This difference was highly significant (p = 0.0013), supporting the hypothesis that cross-sensitivity between aspirin and acetaminophen is unique in aspirin-sensitive asthmatic patients. Conclusion: Although high-dose (>1000 mg) acetaminophen cross-reactions with aspirin were significant with respect to frequency (34%), such reactions included easily reversed bronchospasm in only 22%, and were generally mild. We recommend that high doses of acetaminophen (1000 mg or greater) should be avoided in aspirin-sensitive asthmatic patients. (J Allergy Clin Immunol 1995;96:480-5.). © 1995 Mosby, Inc. All rights reserved.




Settipane, R. A., Schrank, P. J., Simon, R. A., Mathison, D. A., Christiansen, S. C., & Stevenson, D. D. (1995). Prevalence of cross-sensitivity with acetaminophen in aspirin-sensitive asthmatic subjects. The Journal of Allergy and Clinical Immunology, 96(4), 480–485.

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