Abstract
Non-steroidal anti-inflammatory drugs are used daily by millions of patients worldwide for the management of various inflammatory diseases. Many well-documented adverse reactions are related to the use of these drugs. We report a fifty-four year-old woman with anaphylaxis after ingestion of ibuprofen liquid in a gelatin capsule. Eventually this was concluded to have resulted from hypersensitivity to the gelatin component of the capsule, which was likely IgE-mediated because of the positive skin test to gelatin. Gelatin allergy is only relevant for patients ingesting specific capsule formulation. The allergist/clinical immunologist must keep in mind the possibility of gelatin allergy.
Highlights
Non-steroidal anti-inflammatory drugs (NSAIDs) play an enormous role in the management of inflammatory diseases and as analgesics
We present a case of anaphylaxis after ingestion of ibuprofen in a gelatin capsule
Due to failure to follow-up, we were unable to evaluate for reactions to other gelatincontaining food or medical products, neither we were able to evaluate for in vitro specific-IgE against bovine gelatin
Summary
Non-steroidal anti-inflammatory drugs (NSAIDs) play an enormous role in the management of inflammatory diseases and as analgesics. The patient had no previously known food or medication allergies She recalled having ingested cucumber and ibuprofen around the same time as having fresh tomato. Her past medical history is significant for asthma controlled with inhaled steroids and occasional short acting beta-agonists. The patient was asked to bring the specific brand of ibuprofen she had been using to the clinic on the visit On her follow-up visit, she reported development of a similar but more severe reaction, associated with hypotension; i.e: grade 3 anaphylaxis [3], after ingesting only one tablet of the same drug with no other co-ingestions. Due to failure to follow-up, we were unable to evaluate for reactions to other gelatincontaining food or medical products, neither we were able to evaluate for in vitro specific-IgE against bovine gelatin
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