Multiple nonsteroidal anti-inflammatory drug hypersensitivity without hypersensitivity to aspirin

According to current guidelines, such individuals must be considered single responders to multiple drugs, even if they respond to several NSAIDs from different chemical groups. In addition to good tolerance to ASA, we confirmed that this patient was a selective responder by also administering the full therapeutic dose of ibuprofen (also considered a strong COX-1 inhibitor) and observing tolerance. Because all the reactions occurred less than 1 hour after drug intake, we consider them to be immediate selective responses to these drugs, as reviewed by Canto et al.5 We believe that the term "multiple selective responders to NSAIDs" should be used to differentiate patients with these characteristics from cross-hypersensitive patients.