Celecoxib-Associated Anaphylaxis

• DOI: 10.1345/aph.1l593
• Publication Date: 2009-03-19T02:30:41Z
• Authors: Kevin W Chamberlin; Adam R Silverman
• Keywords: Celecoxib

To report and discuss a case of anaphylaxis in young, healthy white male taking celecoxib for intermittent lower back pain.A 27-year-old man with documented history to penicillins macrolides presented the emergency department (ED) anaphylactic shock after ingesting 200-mg capsule cup orange juice. The patient had been over past 6 months, 1-2 weeks at time, low pain secondary pilonidal cyst an L5/S1 bulging disc. day admission was seventh most recent course twice-daily celecoxib. initially self-treated reaction diphenhydramine subcutaneous epinephrine that he home due his drug- bee sting-induced anaphylaxis; neither intervention improved symptoms. He became profoundly diaphoretic developed systemic swelling, shortness breath, bradycardia, hypotension. Emergency medical services transported ED, where treated appropriately symptoms resolved. However, 4 hours later, time discharge from recurred. admitted intensive care unit monitored 3 days. Supportive care, steroids, histamine blockade provided resolution Cardiac workup initiated because recurrence severity bradycardia hypotension; results were unremarkable. discharged stable condition.This demonstrates rare who previously taken drug tolerance sulfonamide antibiotics. Despite this history, our type V immunoglobulin E-mediated component This considered probable according Naranjo probability scale. A review published reports related allergy literature allergenicity revealed such reactions are rare. is first great detail having tolerated medication.Celecoxib can produce patients have antibiotics also reviews potentially biphasic presentation anaphylaxis. Clinicians need be aware response ensure optimal duration evaluation.