Acetylsalicylic acid (ASA)-augmentation in relation to ASA-intolerance

Abstract

The mechanism of ASA-intolerance remains unclear. We describe four cases presenting a new allergic phenomenon. In these patients food-allergies were proven by skin testing, specific IgE and oral provocation. Thereafter, the oral challenge was repeated with simultaneous intake of ASA. The allergic reactions after food challenge were mild (oropharyngeal symptoms). ASA without food allergen was tolerated in all four patients. The simultaneous intake of the food allergen and ASA, however, led to dramatic reactions and augmentation of the food allergy, i.e. generalized urticaria, severe rhinitis and even shock. The newly described phenomenon of ASA-augmentation might bei related to ASA-intolerance and sheds new light on the possible mechanisms of ASA-intolerance in patients with chronic urticaria.