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Open Access Case report

Description of 3 Cases in Vietnam of Aspirin Desensitization in Patients With Coronary Artery Disease and Coexisting Aspirin Hypersensitivity

Dinh Van Nguyen12*, Hieu Chu Chi2, Doan Van Nguyen12, Timothy J Craig3 and Sheryl van Nunen45

Author Affiliations

1 Allergy Department, Hanoi Medical University, Hanoi, Vietnam

2 Center of Allergology and Clinical Immunology, Bach Mai Hospital, Hanoi, Vietnam

3 Section of Allergy, Asthma and Immunology, Pennsylvania State University, Hershey, PA

4 Sydney Medical School-Northern, University of Sydney, Sydney, Australia

5 Department of Clinical Immunology and Allergy, Royal North Shore Hospital, Sydney, Australia

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World Allergy Organization Journal 2012, 5:170-173  doi:10.1097/WOX.0b013e3182718327

Published: 15 November 2012

Abstract

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.

Keywords:
Vietnam; aspirin (ASA) hypersensitivity; ASA desensitization; coronary artery disease