Successful desensitization treatment for a patient with aspirin allergy

A 77-year-old female patient received combined antiplatelet therapy with aspirin enteric-coated tablets (100 mg once daily) and clopidogrel (75 mg once daily) orally because of acute ischemic stroke. Three days after medication, she developed rashes all over the body, accompanied by itching. No treatment was given. Three weeks later, clopidogrel was stopped and single antiplatelet therapy (aspirin enteric-coated tablets 100 mg once daily) was given. After that, the rashes did not subside for more than a month. Aspirin was stopped by herself. About 1 week later, the rashes subsided. Then the patient took original dose of aspirin again by herself for about 1 month, the above-mentioned symptoms recurred. Because she needed long-term single antiplatelet therapy, aspirin desensitization was given. Firstly, aspirin enteric-coated tablets were dissolved in warm water to make up the solution of 5 mg/ml. After the initial oral administration of 0.2 ml (equivalent to aspirin 1 mg), 1, 2, 4, 8 and 20 ml (equivalent to aspirin 1, 5, 10, 20, 40 and 100 mg) were given orally at 30, 60, 90, 210 and 330 minutes, respectively. The desensitization therapy lasted 5.5 hours. Anaphylactic reaction did not appear during the process of desensitization therapy. Then she took original dose of aspirin enteric-coated tablets followed the doctor′s advice. At 4 months of follow-up, rashes did not recur, suggesting that desensitization therapy was successful. Key words: Aspirin; Desensitization, immunologic; Clopidogrel