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PubMed · 1035401

[Chronic urticaria. Provocation test].

J M Giménez Camarasa
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Abstract

Sixty patients of ages ranging from 11 to 64, with chronic urticaria from 2 months to 50 years duration, were studied with the provocation test. We found responses in 33.3% of patients. Tartrazine was the most common inducer, specially in those patients sensitive to aspirin with increased salicilate blood levels. As we did not use aspirin as inducer the results with tartrazine are more relevant and can be used to detect a positive response to aspirin. The relation between tartrazine and aspirin was not observed in patients with pressure or cholinergic urticaria. The provocation test is most useful in patients with chronic urticaria of unknown cause. 4 hydroxybenzoic acid and sodium acid and sodium benzoate were the more common inducers in the latter patients. We feel that the provocation test is a useful tool to study patients with chronic urticaria. Tartrazine, 4 hydroxybenzoic acid, sodium benzoate, tiramin and penicilin are included in the test. The responders should eliminate the offender from their diet.

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AspirinBenzoatesChronic DiseaseDiagnostic Uses of ChemicalsHumansHydroxybenzoatesMethodsPenicillin GPharmaceutical PreparationsTartrazineTyramineUrticariaEnglish AbstractJournal Article

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J M Giménez Camarasa. 1976. [Chronic urticaria. Provocation test].. https://pubmed.ncbi.nlm.nih.gov/1035401/

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Rapid desensitization protocols for patients with cardiovascular disease and aspirin hypersensitivity in an era of dual antiplatelet therapy.

OBJECTIVE: To review the available protocols for rapid desensitization of patients with aspirin hypersensitivity and apply the data for use in patients with cardiovascular disease who would benefit from the dual antiplatelet therapy. DATA SOURCES: A literature search was conducted via MEDLINE from 1966 to December 2006. Main search terms included: aspirin sensitivity, aspirin allergy, aspirin desensitization, aspirin-induced asthma, aspirin therapy, and aspirin intolerance syndrome. STUDY SELECTION AND DATA EXTRACTION: Articles describing rapid aspirin desensitization protocols were selected for review. Literature pertaining to aspirin hypersensitivity, drug desensitization, and the use of aspirin and dual antiplatelet therapy was also examined. Three rapid desensitization protocols were identified and evaluated. DATA SYNTHESIS: While landmark studies demonstrated that dual antiplatelet therapy with aspirin and clopidogrel significantly reduces mortality and morbidity in acute coronary syndromes and coronary stenting, patients with aspirin hypersensitivity are frequently managed with clopidogrel alone with no supporting data. Approximately 10% of the population experiences hypersensitivity to aspirin, which can manifest as asthma exacerbations, rhinorrhea, angioedema, urticaria, and anaphylaxis. The hypersensitivity reaction is mediated through aspirin-directed antibodies or by excessive leukotriene production. The desensitization process involved depletion of these mediators, as well as down-regulation of leukotriene receptors. Two groups of investigators developed rapid protocols to desensitize patients with aspirin hypersensitivity safely and effectively. The rapid protocol developed by Wong provides benefits over other protocols with its low starting dose and completion in less than 3 hours, low incidence of adverse effects, and high success rate in aspirin desensitization. CONCLUSIONS: The Wong protocol is an attractive option for the rapid desensitization of patients requiring dual antiplatelet therapy with aspirin and clopidogrel in the perimyocardial infarction period.

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