Two cases of anaphylaxis to diclofenac with aspirin tolerance / 대한내과학회지

ABSTRACT

Anaphylaxis is an acute life-threatening reaction, usually mediated by immunologic and non- immunologic mechanisms. Non-steroidal anti-inflammatory drugs (NSAIDs) can produce anaphylactic reactions by different pathogenic mechanisms. The most of these reactions are elicited by different NSAIDs depending on the potency of the cyclooxygenase inhibition, but other reactions provoked by IgE-dependent mechanism. The NSAIDs most often involved in these kinds of reactions are pyrazolones and aspirin. Diclofenac is a widely used NSAID derivative of phenylacetic acid. Anaphylaxis to diclofenac with aspirin tolerance has been rarely described. Here we report two cases of selective anaphylaxis to diclofenac with good tolerance to aspirin. It may be suggested by IgE-dependent reaction, not by cyclooxygenase inhibition.