Possible relevance of virus infection for development of analgesic idiosyncrasy

Although it has been hypothesized that analgesic idiosyncrasy could be acqu ired by viral infection, there is no evidence that any virus can cause spor adic cases of aspirin-intolerant asthma. We report a case, which points to the possible relevance of herpes simplex virus (HSV) infection for developm ent of analgesic idiosyncrasy. We examined the patient to evaluate whether analgesic idiosyncrasy might have been acquired by viral infection. Sulpyri ne provocation testing was performed to confirm the patient's development o f analgesic idiosyncrasy and methacholine provocation testing was performed to assess bronchial hyperresponsiveness. The titer of anti-HSV IgG antibod y was measured to confirm viral infection. Sulpyrine provocation testing re vealed that hypersensitivity to analgesics had appeared in this patient. In contrast, the marked improvement of her bronchial hyperresponsiveness was confirmed by a PC20 methacholine of 0.63 mg/ml 1 week after sulpyrine provo cation testing. The anti-HSV IgG antibody confirmed recent HSV infection. T o the best of our knowledge, this is the first reported case of acquired an algesic idiosyncrasy following HSV infection. Copyright (C) 2001 S. Karger AG, Basel.