Ra. Settipane et al., PREVALENCE OF CROSS-SENSITIVITY WITH ACETAMINOPHEN IN ASPIRIN-SENSITIVE ASTHMATIC SUBJECTS, Journal of allergy and clinical immunology, 96(4), 1995, pp. 480-485
Objective: Cross-sensitivity between aspirin and acetaminophen in aspi
rin-sensitive asthmatic patients has been reported with frequencies ra
nging from 0% to 29%. The relationship is dose-dependent for acetamino
phen challenges, ranging between 300 and 1000 mg. Methods: To determin
e the prevalence of cross-sensitivity to high-close acetaminophen, we
performed single-blind acetaminophen oral challenges with 1000 mg and
1500 mg in 50 aspirin-sensitive asthmatic patients and in 20 non-aspir
in-sensitive asthmatic control subjects. Results: Overall, 17 of 50 (3
4%) of aspirin-sensitive asthmatic patients reacted to acetaminophen i
n doses of 1000 to 1500 mg (95% confidence interval: 20% to 49%). By c
ontrast, none of the 20 non-aspirin-sensitive asthmatic patients react
ed to acetaminophen (95% confidence interval: 0% to 14%). This differe
nce was highly significant (p = 0.0013), supporting the hypothesis tha
t cross-sensitivity between aspirin. and acetaminophen is unique in as
pirin-sensitive asthmatic patients. Conclusion: Although high-dose (>1
000 mg) acetaminophen cross-reactions with aspirin were significant wi
th respect to frequency (34%), such reactions included easily reversed
bronchospasm in only 22%, and were generally mild. We recommend that
high doses of acetaminophen (1000 mg or greater) should be avoided in
aspirin-sensitive asthmatic patients.