1Allergy Department, Hanoi Medical University, Hanoi, Vietnam 2Center of Allergology and Clinical Immunology, Bach Mai Hospital, Hanoi, Vietnam 3Section of Allergy, Asthma and Immunology, Pennsylvania State University, Hershey, PA 4Sydney Medical School-Northern, University of Sydney, Sydney, Australia 5Department of Clinical Immunology and Allergy, Royal North Shore Hospital, Sydney, Australia.
World Allergy Organ J. 2012 Nov;5(11):170-3. doi: 10.1097/WOX.0b013e3182718327.
: Aspirin (ASA) hypersensitivity comprises types I to III (Cox-1 mediated) and types IV and V (IgE antibody mediated). Rapid, low-dose (81-325 mg/day) ASA desensitization regimens are known to be useful in establishing ASA tolerance in patients with coronary artery disease and coexisting ASA/nonsteroidal anti-inflammatory drug hypersensitivity. We document 3 cases in Vietnam of desensitization to ASA in patients with coronary artery disease and coexisting ASA hypersensitivity. One of these 3 patients had probable immune-mediated hypersensitivity, whereas the remaining 2 had probable Cox-1-mediated reactions. The regimen of desensitization we employed for each patient was designed to account for the probable mechanism of hypersensitivity in the individual and further modified according to the degree of tolerance observed, with all 3 patients eventually achieving a daily cardioprotective dosage of ASA.
阿司匹林(ASA)过敏包括 I 型至 III 型(Cox-1 介导)和 IV 型和 V 型(IgE 抗体介导)。已知快速、低剂量(81-325mg/天)ASA 脱敏方案可用于在患有冠状动脉疾病和共存的 ASA/非甾体抗炎药过敏的患者中建立 ASA 耐受性。我们在越南记录了 3 例患有冠状动脉疾病和共存的 ASA 过敏的患者的 ASA 脱敏情况。这 3 例患者中有 1 例可能存在免疫介导的过敏反应,而其余 2 例可能存在 Cox-1 介导的反应。我们为每位患者设计的脱敏方案旨在考虑个体过敏反应的可能机制,并根据观察到的耐受性程度进一步进行调整,所有 3 例患者最终均达到了每日心脏保护剂量的 ASA。