Problem: Antiphospholipid syndrome (APS) is associated with thrombosis and poor pregnancy outcome in the presence of antiphospholipid antibodies (aPL). Patients with aPL have a high risk of foetal loss. However, with low-dose aspirin (acetylsalicylic acid; ASA) in combination with subcutaneous heparin, the chances of full-term delivery increase. Nevertheless, ASA treatment is avoided in pregnant, ASA-sensitive women with APS.
Methods: Rapid oral challenge-desensitization to ASA was performed in four pregnant women with a history of APS and aspirin sensitivity. In three patients, desensitization was performed during pregnancy and before the next pregnancy in the fourth. Desensitization was carried out in the ICU using increasing doses of aspirin (0.1-125 mg) over a 24-hr period.
Results: Successful ASA desensitization was achieved in all the patients. No severe side effects occurred during the desensitization test. Only one patient required a small oral dose of antihistamines.
Conclusions: Aspirin desensitization may be a safe alternative even during pregnancy if carefully monitored and permit patients with APS to receive treatment with ASA. This would constitute a new indication in pregnant women with APS and ASA sensitivity.
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http://dx.doi.org/10.1111/j.1600-0897.2005.00322.x | DOI Listing |
Curr Opin Allergy Clin Immunol
February 2025
Ellsworth and Mabel Simmons Professor of Allergy and Immunology, Section Chief, Allergy/Immunology James A. Haley VA Hospital, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Purpose Of Review: This review provides the current understanding on the mechanism, diagnosis, and treatment of aspirin exacerbated respiratory disease (AERD) with chronic rhinosinusitis (CRS).
Recent Findings: Updates focus on the current understanding of type 2 inflammation as a disease driver, alterations in gene expression in nasal polyps, and use of biologics in treating aspirin exacerbated respiratory disease. Recent findings include altered expression of GATA binding protein 3 (GATA3), interleukin (IL)-4, IL-5, and IL-17 in nasal polyps supports the current understanding that type 2 inflammation predominantly drives the pathophysiology of AERD with CRS.
Int Forum Allergy Rhinol
January 2025
Department of Otorhinolaryngology, Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Cureus
September 2024
Internal Medicine, Monmouth Medical Center, Rutgers University, Long Branch, USA.
Aspirin is used in patients with coronary artery disease essential in both acute and chronic phases of treatment, especially post-catheterization and post-coronary artery stent placement. Some patients have sensitivity to aspirin. Hypersensitivity reaction symptoms include itchy and watery eyes, itchy rash, worsening asthma, wheezing to fatal angioedema, and anaphylaxis.
View Article and Find Full Text PDFBiomolecules
October 2024
Dipartimento di Scienze Cardiovascolari-CUORE, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Acetylsalicylic acid (ASA) represents a cornerstone of antiplatelet therapy for the treatment of atherosclerotic coronary artery disease (CAD). ASA is in fact indicated in case of an acute coronary syndrome or after a percutaneous coronary intervention with stent implantation. Aspirin hypersensitivity is frequently reported by patients, and this challenging situation requires a careful evaluation of the true nature of the presumed sensitivity and of its mechanisms, as well as to differentiate it from a more frequent (and more easily manageable) aspirin intolerance.
View Article and Find Full Text PDFJ Am Coll Cardiol
October 2024
Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, USA. Electronic address:
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