Allergic Reaction to Meperidine in a Patient with Aspirin Idiosyncrasy / 대한내과학회지

ABSTRACT

Although narcotic analgesics are potent releasers of histamine, IgE-mediated allergic reactions to these drugs are rare. Here we report the case of a 56-year-old male who suffered from chronic urticarial and analgesics-induced skin rashes. He visited our allergy clinic to determine alternative analgesics before undergoing surgery. A drug provocation test showed a positive reaction to aspirin, but negative reactions to acetaminophen and celecoxib. Despite careful attention to his drug regimen, during surgery he developed generalized urticaria and flushing. Skin tests of allergy to latex, lidocaine, propofol, rocuronium, flomoxef, meperidine, palonosetron, pyridostigmine, and fentanyl yielded negative results, except for the prick and intradermal tests with meperidine. Thus, this patient had both an aspirin/non-steroidal anti-inflammatory drugs idiosyncrasy and an IgE-mediated hypersensitivity to meperidine.