Supplementary Material for: An unusual localized reaction of conjunctivitis with systemic use of Ketoprofen – a case report

Introduction: Although the eye is rarely the sole target of an immediate allergic-type response, ocular signs and symptoms often represent the most prominent features of systemic allergic reactions. Nonsteroidal anti-inflammatory drugs (NSAIDs), due to their cyclooxygenase (COX) inhibitory activity, can trigger non-allergic hypersensitivity responses. Ketoprofen, in particular, is one of the most potent COX inhibitors at therapeutic plasma concentrations and is recognized as a frequent photoallergic agent. However, localized hypersensitivity reactions following systemic administration are exceedingly rare. This report describes an unusual case of allergic conjunctivitis occurring after oral administration of ketoprofen. Case presentation: A 13-year-old Caucasian girl presented to the pediatric emergency department of a private hospital with swelling, progressive ocular redness, burning, itching, and upper airway obstruction. These symptoms developed shortly after the oral administration of ketoprofen (20 mg/mL), prescribed to manage a low-grade fever (37.9°C) and sore throat. No additional systemic manifestations were observed. Conclusion: An uncommon case of conjunctivitis following oral ketoprofen use highlights the need for further research on NSAID-induced hypersensitivity and the value of detailed laboratory evaluation to clarify its causes.

引言：尽管眼部极少成为速发型变态反应的唯一受累靶组织，但眼部体征与症状往往是全身变态反应最突出的临床表现。非甾体抗炎药（Nonsteroidal anti-inflammatory drugs, NSAIDs）凭借其环氧化酶（cyclooxygenase, COX）抑制活性，可诱发非变应性超敏反应。其中酮洛芬（Ketoprofen）是治疗血浆浓度下活性最强的COX抑制剂之一，且被公认为常见的光致敏剂。然而，全身给药后引发的局部超敏反应极为罕见。本报告记述了1例口服酮洛芬后发生的罕见变应性结膜炎病例。
病例报告：1例13岁白人女童因眼部肿胀、进行性结膜充血、灼热感、瘙痒及上气道梗阻，前往某私立医院的儿科急诊就诊。上述症状在口服用于治疗低热（37.9℃）与咽痛的处方药物酮洛芬（20 mg/mL）后不久发作。未观察到其他全身受累表现。
结论：1例口服酮洛芬后出现结膜炎的罕见病例，提示需进一步开展非甾体抗炎药诱导超敏反应的相关研究，同时详细的实验室检查对明确其病因具有重要价值。