Hipersensibilidad selectiva a inhibidores de la ciclooxigenasa-2
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Keywords

COXIB, NSAID, celecoxib, etoricoxib, hypersensitivity.

Abstract

Background The cyclooxygenase-2 inhibitors are usually recommended as a safe alternative in patients with multiple hypersensitivity to nonsteroidal antiinflammatory drugs. Nevertheless, both immediate and delayed hypersensitivity reactions have been described, and also the possibility of cross-reactivity with sulphonamides.

Case report A 66-year-old patient who, after taking a celecoxib tablet, presented with latency of several hours a skin reaction. Previously, he had presented a minor reaction during treatment with etoricoxib without establishing the correlation at that time. The patient underwent an allergological study by means of skin tests with negative results and an oral challenged test with etoricoxib with positive results. Tolerance to sulfonamides was proven.

Conclusion We present a singular case of a cross-reactivity skin reaction to etoricoxib and celecoxib, suggesting the need to perform challenge tests to confirm the tolerance or not of each drug before allowing their use. On the contrary, trimethropim/sulfamethoxazole could be safely used in our patients, if needed.

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References

Morales DR, Lipworth BJ, Guthrie B, et al. Safety risks for patients with aspirin-exacerbated respiratory disease after acute exposure to selective nonsteroidal anti-inflammatory drugs and COX-2 inhibitors: Meta-analysis of controlled clinical trials. J Allergy Clin Immunol 2014;134(1). DOI: 10.1016/j.jaci.2013.10.057

Kowalski ML, Asero R, Bavbek S, et al. Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs. Allergy 2013;68(10):1219–32. DOI: 10.1111/all.12260

CIMA. Resultados de la búsqueda de medicamentos [Internet]. [cited 2021 Jun 14]. Available from: https://cima.aemps.es/cima/publico/lista.html

Couto M, López-Salgueiro R, Gaspar A. Anaphylaxis to etoricoxib. J Investig Allergol Clin Immunol 2018;28(2):135–6. DOI: 10.18176/jiaci.0221

Ponce V, Muñoz-Bellido F, Moreno E, et al. Fixed drug eruption caused by etoricoxib with tolerance to celecoxib and parecoxib. Contact Dermatitis 2012;66: 107–8. DOI: 10.1111/j.1600-0536.2011.01982.x

Venturini Díaz M, San Juan de la Parra S, Segura Arazuri N. Selective immediate hypersensitivity to etoricoxib. J Investig Allergol Clin Immunol 2008;18(6):485–7.

Layton D, Marshall V, Boshier A, et al. Serious skin reactions and selective COX-2 inhibitors: A case series from prescription-event monitoring in England. Drug Saf 2006;29(8):687–96. DOI: 10.2165/00002018-200629080-00005

Regis AC, Germann CA, Crowell JG. Myocardial infarction in the setting of anaphylaxis to celecoxib: A case of kounis syndrome. J Emerg Med 2015;49(2):e39–43. DOI: 10.1016/j.jemermed.2015.02.044

Knowles S, Shapiro L, Shear NH. Should celecoxib be contraindicated in patients who are allergic to sulfonamides? Revisiting the meaning of ‘sulfa’ allergy. Drug Saf 2001;24(4):239–47. DOI: 10.2165/00002018-200124040-00001

Figueroa J, Ortega N, Almeida L, et al. Sulfonamide allergy without cross-reactivity to celecoxib. Allergy Eur J Allergy Clin Immunol 2007;62(1):93. DOI: 10.1111/j.1398-9995.2006.01270.x

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