Fatal allergic vasculitis associated with celecoxib

Lancet. 2002 Mar 9;359(9309):852-3. doi: 10.1016/S0140-6736(02)07922-9.


We report on the occurrence of a rare and as yet unforseeable adverse reaction to treatment with celecoxib, a cyclooxygenase-2 (COX-2) selective, non-steroidal, anti-inflammatory drug. A previously healthy adult suffered fatal acute multiple organ failure presumably after diffuse allergic vasculitis with diffuse necrotic purpura. Although no conclusive proof is available, such a reaction could have been triggered by at least one of two mechanisms: an allergic reaction linked to the chemical structure of celecoxib; or an interaction of the drug with synthesis of endothelial eiconasoids leading to an imbalance between vasoactive end products, resulting in widespread rise to local thrombosis.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Celecoxib
  • Cyclooxygenase Inhibitors / adverse effects*
  • Fatal Outcome
  • Humans
  • Male
  • Middle Aged
  • Multiple Organ Failure / etiology
  • Pyrazoles
  • Sulfonamides / adverse effects*
  • Vasculitis, Leukocytoclastic, Cutaneous / chemically induced*
  • Vasculitis, Leukocytoclastic, Cutaneous / pathology


  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase Inhibitors
  • Pyrazoles
  • Sulfonamides
  • Celecoxib