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.