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I have followed the various articles, reports and correspondence in
the BMJ on this subject.
I am very surprised that none of the contributors have mentioned the
place of COX II inhibitors in the substantial minority of the population
who are intollerant of Aspirin and traditional COX II inhibitor NSAIDs.
In our clinic we see these patients frequently. The reaction to
NSAIDs is anything from an exacerbation of urticaria (30% of CIU),
angioedema, wheeze, through to full anaphylactoid reactions and cardiac
The above group of patients are often tollerant of COX II inhibitors
and their use for analgesic and anti-inflammatory purposes is extremely
usefull. At our clinic we offer an oral challenge to celecoxib in these
Marise McQueen, MB ChB, MRCGP, FFARCS.
No competing interests
20 June 2006
Marise A McQueen
Clinical Assistant at West of Scotland Anaphylaxis Service.