When "Safe" Isn't Safe: Confirmed Paracetamol-Induced Anaphylaxis Diagnosed by Drug Provocation Testing

Paracetamol (acetaminophen) can, in rare cases, induce anaphylaxis, and a drug provocation test (DPT) is considered the gold standard for diagnosis. However, due to the high risk involved with a life-threatening reaction, DPT is generally only performed under strict medical supervision when the history is unclear, and skin tests are inconclusive. Acetaminophen is the most commonly used antipyretic in children. However, there are limited data assessing hypersensitivity reactions related to acetaminophen usage. Paracetamol is a common antipyretic/ analgesic and a component of many prescription and over-the-counter preparations. Hypersensitivity reactions to paracetamol appear to be increasing, but there are few prevalence data.