A case of acetaminophen induced bronchial asthma -without aspirin sensitivity-

Abstract

Acetaminophen is a widely used analgesic-antipyretic. Hypersensitivity reactions to acetami-nophen are rare and selective sensitivity to acetaminophen without aspirin or non-steroidal antiinflammatory drug intolerance is even rarer. We experienced a case of acetaminophen- induced bronchial asthma without aspirin sensitivity. An oral challenge test upto 650mg of Tylenol demonstrated urticaria and dyspnea with greater than 20% decrease of FEV1. Both oral provocation test with 500mg of aspirin and lysine-aspirin bronchoprovocation test showed negative results. In conclusion, we report a case of acetaminophen-induced asthma without aspirin sensitivity. Cyclo-oxygenase inhibition may not be a pathogenic mechanism of acetaminophen-induced bronchial asthma. Further studies will be needed to clarify the mechanism of this reaction.