아스피린 과민성을 동반하지 않은 Propyphenazone 유발성 천식 1예

Abstract

Propyphenazone (1,2-dihydro-l,5-dimethyl-4-(isopropyl)-2-phenyl-pyrazol-3-one: isopropylantipyrine) is a nonsteroidal anti-inflammatory drug (NSAID) and widely used as a mild analgesic. Allergy-like reactions, such as urticaria, anaphylaxis, hemolytic anemia and serum sickness, have been regarded as pseudoallergic or intolerant reactions to this drug. Herein we report a case with propyphenazone-induced bronchoconstriction without cross-reaction with aspirin or acetaminophen. A 33-year-old female patient presented with cough and dyspnea which aggravated after taking NSAID compounds containing propyphenazone. To find the component inducing bronchial hyperresponsiveness, oral provocation tests were performed with aspirin, acetaminophen, NSAID compounds containing propyphenazone, and pure propyphenazone, respectively. After an oral challenge with NSAID compound containing propyphenazone or pure propyphenazone (150 mg), she showed significant changes in FEV1. However, an oral provocation test with aspirin (500 mg) or acetaminophen (900 mg) demonstrated negative results. This case was confirmed as asthma induced by propyphenazone without aspirin and acetaminophen sensitivity.